NPI 1013417104

Troy Adam Haselip, OWNER

Practitioner Driver Lebanon, OR

Practice location

Address: 39349 River Dr, Lebanon, OR 97355-8915
Phone: (541) 971-5469

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence 9570911 (OR)

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Registry record

NPI: 1013417104
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Feb 2018
Record last updated: 15 Feb 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.