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1841805959
KORBEN J CHESNUT-PETRY
SALEM, OR
NPI
1841805959
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR 18-02-03)
Enumeration Date
2020-09-15
Last Update Date
2020-09-15
Business Address
KORBEN J CHESNUT-PETRY CADC 1
1325 COMMERCIAL ST SE
SALEM, OR 97302-4205
Phone number: 971-301-9574
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Mailing Address
KORBEN J CHESNUT-PETRY CADC 1
1160 LIBERTY ST SE
SALEM, OR 97302-4143
Phone number: 503-391-9762
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