| NPI | 1013391671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA LYNN HERGET Lmt #15856 / Owner 541-948-7090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: OR 15856) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2015-07-14 |