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1598396574
GREGORY BRIDGES
ROSEBURG, OR
NPI
1598396574
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR T-19-615)
Enumeration Date
2020-01-29
Last Update Date
2020-01-29
Business Address
GREGORY BRIDGES
621 W MADRONE ST
ROSEBURG, OR 97470-3090
Phone number: 541-672-2691
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Mailing Address
GREGORY BRIDGES
PO BOX 1121
ROSEBURG, OR 97470-0254
Phone number:
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