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1144789520
MICAH ATWOOD
LEBANON, OR
NPI
1144789520
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2019-03-15
Last Update Date
2019-03-15
Business Address
MICAH ATWOOD
200 MULLINS DR
LEBANON, OR 97355
Phone number: 253-341-8022
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Mailing Address
MICAH ATWOOD
200 MULLINS DR
LEBANON, OR 97355
Phone number:
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