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1952976979
TRAVIS CLARK ACORD
MEDFORD, OR
NPI
1952976979
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2021-05-21
Last Update Date
2021-05-21
Business Address
TRAVIS CLARK ACORD
1191 HAZEL ST
MEDFORD, OR 97501
Phone number: 541-476-2373
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Mailing Address
TRAVIS CLARK ACORD
1215 SW G ST
GRANTS PASS, OR 97526-2544
Phone number: 541-476-2373
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