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1700143278
IVAN RUDOLPH MINCH
ROSEBURG, OR
NPI
1700143278
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2012-04-20
Last Update Date
2012-04-20
Business Address
-- IVAN RUDOLPH MINCH
621 W MADRONE ST
ROSEBURG, OR 97470-3090
Phone number: 541-464-6334
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Mailing Address
-- IVAN RUDOLPH MINCH
621 W MADRONE ST
ROSEBURG, OR 97470-3090
Phone number: 541-464-6334
Copy
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