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1558074724
ANDREW LATAILLE
LEBANON, OR
NPI
1558074724
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-01-03
Last Update Date
2023-01-03
Business Address
ANDREW LATAILLE
200 MULLINS DR
LEBANON, OR 97355-3983
Phone number: 541-259-0235
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Mailing Address
ANDREW LATAILLE
200 MULLINS DR
LEBANON, OR 97355-3983
Phone number: 541-259-0235
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