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1295161701
THERONE CAMBA CHAN
MEDFORD, OR
NPI
1295161701
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Additional Taxonomies
171M00000X Case Manager/Care Coordinator
Enumeration Date
2013-09-17
Last Update Date
2019-06-21
Business Address
Mr. THERONE CAMBA CHAN BS
3501 EXCEL DR
MEDFORD, OR 97504-8067
Phone number: 541-476-2373
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Mailing Address
Mr. THERONE CAMBA CHAN BS
1215 SW G ST
GRANTS PASS, OR 97526-2544
Phone number: 541-476-2373
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