Individual
TROY LEWELLYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
603 MEDICAL PKWY, ENTERPRISE, OR 97828-5124
(541) 426-4502
(541) 426-6403
Mailing address
603 MEDICAL PKWY, ENTERPRISE, OR 97828-5124
(541) 426-4502
(541) 426-6403
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
109628
OR
Other
Enumeration date
10/16/2023
Last updated
10/16/2023
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