DERECK BALBONTIN

PORTLAND, OR
NPI1811353063
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy172M00000X Mechanotherapist
(Licence: OR  20563)
Enumeration Date2016-01-04
Last Update Date2016-01-15
Business Address
-- DERECK BALBONTIN
4160 NE SANDY BLVD
PORTLAND, OR 97212-5336
Phone number: 503-249-9000
Mailing Address
-- DERECK BALBONTIN
1130 NE 64TH AVE
PORTLAND, OR 97213-4912
Phone number: 813-470-0322
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