Most Relevant Information
Provider Data
| NPI Number: | 1003050428 |
| Provider Name: | JAY D BERRYMAN |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/29/2009 |
| Last Updated: | 04/29/2009 |
Provider Practice Location
2200 4TH ST
BAKER CITY
OR
978142615
Practice Location Phone/Fax
| Phone: | 5415233646 |
| Fax: | 5415237602 |
Provider Mailing Location
2200 4TH ST
BAKER CITY
OR
978142615
Provider Mailing Phone/Fax
| Phone: | 5415233646 |
| Fax: | 5415237602 |