| NPI | 1083745038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN BRUCE STOUT Owner Physician 541-484-4339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD15846) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |