Most Relevant Information
Provider Data
| NPI Number: | 1003694001 |
| Provider Name: | CASEY LEE LUCY STINE |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/20/2023 |
| Last Updated: | 09/20/2023 |
Provider Practice Location
500 MONROE ST
MEDFORD
OR
975013522
Practice Location Phone/Fax
| Phone: | 5416086868 |
| Fax: |
Provider Mailing Location
500 MONROE ST
MEDFORD
OR
975013522
Provider Mailing Phone/Fax
| Phone: | 5416086868 |
| Fax: |