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1992796486
JOHN A. BACON
CORVALLIS, OR
NPI
1992796486
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: OR LCSW #975)
Enumeration Date
2005-11-02
Last Update Date
2007-07-08
Business Address
Mr. JOHN A. BACON LCSW
525 SW 6TH ST
CORVALLIS, OR 97333-4323
Phone number: 541-752-0834
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Mailing Address
Mr. JOHN A. BACON LCSW
525 SW 6TH ST
CORVALLIS, OR 97333-4323
Phone number: 541-752-0834
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