| NPI | 1053727636 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP ANTICOAGULATION TELEPHONE MANAGEMENT |
| Entity Type | Organization |
| Authorized Contact | KEENAN B FREEMAN CFO 503-893-6524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2014-07-14 |