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1114545787
CHARLES JOSEPH DEZORT
BEND, OR
NPI
1114545787
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2020-07-10
Last Update Date
2020-07-10
Business Address
CHARLES JOSEPH DEZORT
63311 JAMISON ST
BEND, OR 97703-8288
Phone number: 541-322-7500
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Mailing Address
CHARLES JOSEPH DEZORT
2577 NE COURTNEY DR
BEND, OR 97701-7752
Phone number: 541-322-7500
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