Provider Demographics
NPI:1801426838
Name:DAVID LEVIN
Entity type:Organization
Organization Name:DAVID LEVIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-729-6611
Mailing Address - Street 1:2783 HARDSCRABBLE RD
Mailing Address - Street 2:
Mailing Address - City:DRAIN
Mailing Address - State:OR
Mailing Address - Zip Code:97435-9780
Mailing Address - Country:US
Mailing Address - Phone:541-729-6611
Mailing Address - Fax:
Practice Address - Street 1:3575 DONALD ST STE 620
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-4775
Practice Address - Country:US
Practice Address - Phone:541-729-6611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-17
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty