Provider Information for 1235260431
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DEBORAH K KIRBY
Sex: Female
NPI: 1235260431
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1235260431 | ||||||||
| Enumeration Date | 2007-03-08 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 125 CENTRAL AVE STE. 290 COOS BAY, OR 97420-2316 United States Phone: 541-267-2113 | Fax:541-267-5071 | ||||||||
| Primary Practice Address | 125 CENTRAL AVE STE. 290 COOS BAY, OR 97420-2316 United States Phone: 541-267-2113 | Fax:541-267-5071 | ||||||||
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