Jeryl M Cossette, LMT

Individual provider Active NPI Rehabilitation Chiropractor · Oakridge, OR

NPI 1164627261 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1164627261
Entity type
Individual (NPI type 1)
Primary specialty
Rehabilitation Chiropractor 111NR0400X
License
6936 (OR)
Practice address
76370 Rock Rd
Oakridge, OR 97463-9541
Phone
(541) 782-4416
NPI assigned
Jun 19, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6936ORMDRehabilitation Chiropractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 6936 OR Yes

Addresses

Primary practice location

76370 Rock Rd
Oakridge, OR 97463-9541

Mailing address

76372 Rock Rd
Oakridge, OR 97463-9541
Phone (541) 782-4416

Other providers in Oakridge, OR

All providers in Oakridge, OR · Rehabilitation Chiropractor in Oregon

Sources for this page

Verify at the official NPI Registry.