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1497526222
JEB RILEY WILD
GRESHAM, OR
NPI
1497526222
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: OR 65159)
Enumeration Date
2024-01-10
Last Update Date
2024-01-10
Business Address
MR. JEB RILEY WILD DPT
24076 SE STARK ST STE 200
GRESHAM, OR 97030-3376
Phone number: 503-491-1666
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Mailing Address
MR. JEB RILEY WILD DPT
140 SW COLUMBIA ST APT 1502
PORTLAND, OR 97201-5887
Phone number: 772-971-1144
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