BRODERICK DANIEL BLUES BUCKHOLZ

JASPER, OR
NPI1427756030
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2023-02-22
Last Update Date2023-02-22
Business Address
Mr. BRODERICK DANIEL BLUES BUCKHOLZ BA
37875 JASPER LOWELL RD
JASPER, OR 97438-9751
Phone number: 541-747-1235
Mailing Address
Mr. BRODERICK DANIEL BLUES BUCKHOLZ BA
2620 POTTER ST
EUGENE, OR 97405-4124
Phone number: 503-383-2481
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