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3714 Durst St Medford OR 97504-3715 | |
| (541) 210-7037 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3714 Durst St, Medford, Oregon |
| Authorized Official Name and Position | Alexander Troy (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 5412107037 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3714 Durst St Medford OR 97504-3715 Ph: (541) 210-7037 | 3714 Durst St Medford OR 97504-3715 Ph: (541) 210-7037 |
| NPI Number | 1710703053 |
|---|---|
| Provider Enumeration Date | 12/03/2024 |
| Last Update Date | 12/26/2024 |
| Certification Date | 12/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710703053 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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