KEITH EDWARD MARTIN

ROSEBURG, OR
NPI1184331662
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy175T00000X Peer Specialist
Additional Taxonomies101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2022-11-03
Last Update Date2023-07-20
Business Address
KEITH EDWARD MARTIN
621 W MADRONE ST
ROSEBURG, OR 97470-3090
Phone number: 541-672-2691
Mailing Address
KEITH EDWARD MARTIN
PO BOX 1121
ROSEBURG, OR 97470-0254
Phone number: 541-672-2691
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