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1265131775
MARTIN KENNETH GAITER
EUGENE, OR
NPI
1265131775
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR 108291)
Enumeration Date
2023-02-23
Last Update Date
2023-02-23
Business Address
MARTIN KENNETH GAITER
2411 MLK JR BLVD
EUGENE, OR 97401-5824
Phone number: 541-682-3550
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Mailing Address
MARTIN KENNETH GAITER
2073 OLYMPIC ST
SPRINGFIELD, OR 97477-3413
Phone number: 541-682-3550
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