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1407216260
ANDREW TYLER MEDLOCK
ROSEBURG, OR
NPI
1407216260
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2016-03-07
Last Update Date
2016-03-07
Business Address
-- ANDREW TYLER MEDLOCK
272 MEDICAL LOOP SUITE C
ROSEBURG, OR 97471
Phone number: 541-440-3532
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Mailing Address
-- ANDREW TYLER MEDLOCK
1600 NW GARDEN VALLEY BLVD SUITE 110
ROSEBURG, OR 97471
Phone number: 541-440-3532
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