| NPI | 1083096929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER LIEN HATLESTAD President 541-948-0303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR MD24066) |
| Enumeration Date | 2015-06-28 |
| Last Update Date | 2015-11-17 |