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1114507795
JACKSON DUANE LAW
ENTERPRISE, OR
NPI
1114507795
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
213ES0103X Podiatrist, Foot & Ankle Surgery
(Licence: OR 221041)
Enumeration Date
2021-04-08
Last Update Date
2024-11-05
Business Address
JACKSON DUANE LAW DPM
601 MEDICAL PKWY
ENTERPRISE, OR 97828-5124
Phone number: 541-426-3111
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Mailing Address
JACKSON DUANE LAW DPM
911 HAMEL DR
ENTERPRISE, OR 97828-1437
Phone number: 480-861-3804
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