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1659582823
JEFFREY MYRON FORTY
CORVALLIS, OR
NPI
1659582823
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
104100000X Social Worker
Enumeration Date
2007-05-26
Last Update Date
2007-07-08
Business Address
Mr. JEFFREY MYRON FORTY
4455 NE HIGHWAY 20
CORVALLIS, OR 97330-9695
Phone number: 541-750-1121
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Mailing Address
Mr. JEFFREY MYRON FORTY
4455 NE HIGHWAY 20
CORVALLIS, OR 97330-9695
Phone number: 541-750-1121
Copy
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