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1023281201
ANTHONY B DEJACK
ASHLAND, OR
NPI
1023281201
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2008-04-08
Last Update Date
2008-04-08
Business Address
-- ANTHONY B DEJACK MS
1836 FREMONT ST
ASHLAND, OR 97520-2537
Phone number: 541-482-5792
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Mailing Address
-- ANTHONY B DEJACK MS
1836 FREMONT ST
ASHLAND, OR 97520-2537
Phone number: 541-482-5792
Copy
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