Individual
JHUN DANIELE GRUESO AGONOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3838 PACIFIC AVE, FOREST GROVE, OR 97116-2224
(503) 357-1706
(503) 270-5023
Mailing address
655 S WILLOW ST STE 128, MANCHESTER, NH 03103-5723
(603) 681-9294
(888) 979-6551
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
10156
OR
Other
Enumeration date
05/10/2023
Last updated
05/10/2023
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