Jon Bollweg

NPI #1518219039 in Gladstone, Oregon

Provider Information

NPI Number: 1518219039
Entity Type: Individual
Name: Jon Bollweg
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Adult Companion
Enumeration Date: Oct 8, 2012
Last Updated: Oct 8, 2012

Practice Location

Address: 1020 PORTLAND AVE
City: Gladstone
State: Oregon
ZIP Code: 97027-2155
Phone: (503) 238-0769

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Adult Companion	372600000X	Primary

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