Jack Opgenorth L.C.S.W

NPI 1376679969 - Social Worker - 1041C0700X

NPI Details
NPI 1376679969
Gender Male
Enumeration Date 02/26/2007
Last Updated 02/11/2016
Entity Type Individual
Active Over 9 years ago
Practice Location
1744 E MCANDREWS RD
SUITE B
MEDFORD OR, 97504, US
Phone (541) 776-0821
Fax (541) 776-5011
Business Location
1744 E MCANDREWS RD
SUITE B
MEDFORD OR, 97504, US
Phone (541) 776-0821
Fax (541) 776-5011
Toxanomy
Taxonomy Code 1041C0700X
License State Oregon
License Number L2954
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According to our database, Mr. Jack Opgenorth L.C.S.W NPI is 1376679969, taxonomy code is 1041C0700X and license number is L2954, license state is located at Oregon. Jack Opgenorth L.C.S.W physically located at 1744 E Mcandrews Rd, Medford OR, 97504. NPI Number Jack Opgenorth L.C.S.W has the Individual type.

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1376679969 NPI number is provided on an as is basis without warranty of any kind. 1376679969 is maintained by the National Plan & Provider Enumeration System. The contents of Jack Opgenorth L.C.S.W are for informational purposes only.