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1265484364
MADELYN JO KOONTZ
SALEM, OR
NPI
1265484364
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: OR 24)
Enumeration Date
2006-05-17
Last Update Date
2007-07-08
Business Address
-- MADELYN JO KOONTZ RD, LD
3878 BEVERLY AVE NE
SALEM, OR 97305-1349
Phone number: 503-363-6065
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Mailing Address
-- MADELYN JO KOONTZ RD, LD
3030 LAWNRIDGE ST SW
ALBANY, OR 97321-3444
Phone number: 541-926-9216
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