| NPI | 1053556019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN VAUGHN Insurance Coordinator 541-434-4366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: OR MD19148) |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2008-12-04 |