Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | LMT12298 | OR |
NPI | 1033126339 |
---|---|
Provider Name | Mr. Gregory Bollinger |
First Address | Oregon City, OR 97045-4288 |
Second Address | Oregon City, OR 97045-4288 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 28/08/2012 |