Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 3990 | OR |
NPI | 1003171125 |
---|---|
Provider Name | Ms. Mariane Drygas Pope |
First Address | Mcminnville, OR 97128-9108 |
Second Address | Mcminnville, OR 97128-9108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2012 |
Last Update Date | 05/07/2012 |