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1972519007
GRANT JASON CARSON
BEND, OR
NPI
1972519007
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: OR 5298)
Enumeration Date
2006-07-31
Last Update Date
2020-01-09
Business Address
Mr. GRANT JASON CARSON PT
19879 5TH STREET
BEND, OR 97703
Phone number: 541-588-2646
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Mailing Address
Mr. GRANT JASON CARSON PT
19879 5TH STREET
BEND, OR 97703
Phone number: 541-588-2646
Copy
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