| NPI | 1023366705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD WELCH President Of Corporation 541-479-1982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: OR 1547) |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2012-08-28 |