SUSAN BASILICATO

MEDFORD, OR
NPI1265403851
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy163WG0000X Registered Nurse, General Practice
(Licence: OR  07804146RN)
Enumeration Date2006-01-31
Last Update Date2007-11-26
Business Address
-- SUSAN BASILICATO NP
1200 MIRA MAR AVE
MEDFORD, OR 97504-8546
Phone number: 541-664-5151
Mailing Address
-- SUSAN BASILICATO NP
1208 BEALL LN
CENTRAL POINT, OR 97502-1573
Phone number: 541-664-5151