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1609635846
IAN ROUSSEAU
GRANTS PASS, OR
NPI
1609635846
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: OR 65185)
Enumeration Date
2024-03-18
Last Update Date
2024-03-18
Business Address
IAN ROUSSEAU PT
1485 NE 7TH ST
GRANTS PASS, OR 97526-1303
Phone number: 541-479-6936
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Mailing Address
IAN ROUSSEAU PT
PO BOX 2630
GRANTS PASS, OR 97528-0239
Phone number: 541-479-6936
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