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1194296178
IAN LEUPOLD
COOS BAY, OR
NPI
1194296178
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2018-12-17
Last Update Date
2018-12-17
Business Address
IAN LEUPOLD
2020 THOMPSON RD
COOS BAY, OR 97420-2041
Phone number: 541-267-3511
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Mailing Address
IAN LEUPOLD
1750 NEBRASKA AVE BLDG A
GRANTS PASS, OR 97527-5700
Phone number: 541-956-4943
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