| NPI | 1033857842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW PATRICK EVITTS Owner/Member 541-250-5994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2022-05-23 |
| Last Update Date | 2023-12-29 |