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1871949792
JACK MAXWELL
MCMINNVILLE, OR
NPI
1871949792
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2016-05-10
Last Update Date
2016-05-10
Business Address
-- JACK MAXWELL
627 NE EVANS ST
MCMINNVILLE, OR 97128-3923
Phone number: 503-434-7523
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Mailing Address
-- JACK MAXWELL
627 NE EVANS ST
MCMINNVILLE, OR 97128-3923
Phone number: 503-434-7523
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