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1093263923
LUCAS MCMELLON
SALEM, OR
NPI
1093263923
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2016-09-20
Last Update Date
2016-09-20
Business Address
-- LUCAS MCMELLON
1599 STATE ST
SALEM, OR 97301-4255
Phone number: 503-363-3260
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Mailing Address
-- LUCAS MCMELLON
1599 STATE ST
SALEM, OR 97301-4255
Phone number: 503-363-3260
Copy
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