JONATHAN REX GUSTAVSON

PORTLAND, OR
NPI1003007808
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: OR  4932)
Enumeration Date2007-08-06
Last Update Date2021-12-30
Business Address
JONATHAN REX GUSTAVSON MSPT
3426 NE 62ND AVE
PORTLAND, OR 97213-3953
Phone number: 503-312-3443
Mailing Address
JONATHAN REX GUSTAVSON MSPT
3426 NE 62ND AVE
PORTLAND, OR 97213-3953
Phone number: 503-312-3443
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