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1447800024
BROCK ANTHONY BUMGARNER
GRANTS PASS, OR
NPI
1447800024
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2019-09-16
Last Update Date
2019-09-16
Business Address
BROCK ANTHONY BUMGARNER QMHP
1181 SW RAMSEY AVE
GRANTS PASS, OR 97527-5835
Phone number: 541-476-2373
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Mailing Address
BROCK ANTHONY BUMGARNER QMHP
1215 SW G ST
GRANTS PASS, OR 97526-2544
Phone number: 541-476-2373
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