| NPI | 1033654793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL E DUPUIS Mbr 541-556-6743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR 201505391NP-PP) |
| Enumeration Date | 2017-01-04 |
| Last Update Date | 2018-07-31 |