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1750130290
DEVAN ROBERT LEAGUE
BAKER CITY, OR
NPI
1750130290
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
(Licence: OR pending)
Enumeration Date
2024-05-16
Last Update Date
2024-05-16
Business Address
DEVAN ROBERT LEAGUE
3425 13TH ST
BAKER CITY, OR 97814-1340
Phone number: 541-523-7400
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Mailing Address
DEVAN ROBERT LEAGUE
3425 13TH ST
BAKER CITY, OR 97814-1340
Phone number: 541-523-7400
Copy
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