Provider Demographics
NPI:1952685638
Name:FRANKLIN, DENA K (LMT)
Entity Type:Individual
Prefix:
First Name:DENA
Middle Name:K
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 N RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-4619
Mailing Address - Country:US
Mailing Address - Phone:541-770-1330
Mailing Address - Fax:541-770-7090
Practice Address - Street 1:1240 N RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-4619
Practice Address - Country:US
Practice Address - Phone:541-770-1330
Practice Address - Fax:541-770-7090
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR18429174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist