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1659615920
BEAU J VANDENDOLDER
PORTLAND, OR
NPI
1659615920
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171100000X Acupuncturist
(Licence: OR AC150611)
Enumeration Date
2012-11-26
Last Update Date
2012-11-26
Business Address
-- BEAU J VANDENDOLDER L.Ac
1619 SE FLAVEL ST
PORTLAND, OR 97202-6033
Phone number: 847-800-4077
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Mailing Address
-- BEAU J VANDENDOLDER L.Ac
1619 SE FLAVEL ST
PORTLAND, OR 97202-6033
Phone number:
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