JOHNNY DEBLOCK

SALEM, OR
NPI1801928403
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: OR  DO23311)
Enumeration Date2007-03-09
Last Update Date2007-07-08
Business Address
-- JOHNNY DEBLOCK DO
665 WINTER ST SE
SALEM, OR 97301-3919
Phone number: 503-561-5200
Mailing Address
-- JOHNNY DEBLOCK DO
1413 CEDARCREST CT S
SALEM, OR 97306-2273
Phone number:
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