Most Relevant Information
Provider Data
| NPI Number: | 1003399577 |
| Provider Name: | JUDY LYNN CORRIE |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/11/2018 |
| Last Updated: | 09/11/2018 |
Provider Practice Location
3512 LONE PINE RD
MEDFORD
OR
975045637
Practice Location Phone/Fax
| Phone: | 5417792003 |
| Fax: |
Provider Mailing Location
300 W MAIN ST
MEDFORD
OR
975012756
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |