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1073814208
MARK EMERY CROCKER
CORVALLIS, OR
NPI
1073814208
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2010-11-04
Last Update Date
2011-06-15
Business Address
Mr. MARK EMERY CROCKER
530 NW 27TH STREET
CORVALLIS, OR 97330
Phone number: 541-766-6835
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Mailing Address
Mr. MARK EMERY CROCKER
530 NW 27TH STREET
CORVALLIS, OR 97330
Phone number: 541-766-6835
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