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1407800097
CLIFFORD S LANCE
COOS BAY, OR
NPI
1407800097
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: OR pa00028)
Enumeration Date
2006-05-19
Last Update Date
2007-07-08
Business Address
-- CLIFFORD S LANCE PA
2699 N 17TH ST
COOS BAY, OR 97420-2134
Phone number: 541-266-3600
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Mailing Address
-- CLIFFORD S LANCE PA
2699 N 17TH ST
COOS BAY, OR 97420-2134
Phone number: 541-266-3600
Copy
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