BEAU J VANDENDOLDER

PORTLAND, OR
NPI1659615920
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171100000X Acupuncturist
(Licence: OR  AC150611)
Enumeration Date2012-11-26
Last Update Date2012-11-26
Business Address
-- BEAU J VANDENDOLDER L.Ac
1619 SE FLAVEL ST
PORTLAND, OR 97202-6033
Phone number: 847-800-4077
Mailing Address
-- BEAU J VANDENDOLDER L.Ac
1619 SE FLAVEL ST
PORTLAND, OR 97202-6033
Phone number: