Provider Information for 1174934244
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ELIZABETH GIELE
Sex: Female
NPI: 1174934244
Last Updated: 2014-05-12
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1174934244 | ||||||||
| Enumeration Date | 2014-05-12 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 913 NW GARDEN VALLEY BLVD ROSEBURG, OR 97471-6523 United States Phone: 541-440-1000 | Fax: | ||||||||
| Primary Practice Address | 913 NW GARDEN VALLEY BLVD ROSEBURG, OR 97471-6523 United States Phone: 541-440-1000 | Fax: | ||||||||
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