| NPI | 1013254432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMI J FOSTER Office Manager 541-567-1137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR MD07786) |
| Enumeration Date | 2013-01-04 |
| Last Update Date | 2013-05-06 |