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1235708900
TREVAR JOHN WHITE
ROSEBURG, OR
NPI
1235708900
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2021-06-17
Last Update Date
2021-06-21
Business Address
TREVAR JOHN WHITE
621 W MADRONE ST
ROSEBURG, OR 97470-3090
Phone number: 541-672-2691
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Mailing Address
TREVAR JOHN WHITE
PO BOX 1121
ROSEBURG, OR 97470-0254
Phone number: 541-672-2691
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