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1528569696
DANIEL ETCHISON
MEDFORD, OR
NPI
1528569696
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2018-02-23
Last Update Date
2019-05-02
Business Address
DANIEL ETCHISON CIT
221 W MAIN ST
MEDFORD, OR 97501-2728
Phone number: 541-772-1777
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Mailing Address
DANIEL ETCHISON CIT
221 W MAIN ST
MEDFORD, OR 97501-2728
Phone number:
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