Individual
DR. AGATHA SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
913 NW GARDEN VALLEY BLVD, ROSEBURG, OR 97470-6523
(541) 440-1377
(541) 440-1394
Mailing address
1450 NW MULHOLLAND DR, # 156, ROSEBURG, OR 97470-1942
(620) 802-1220
(541) 673-0901
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA04557700
NJ
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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