| NPI | 1083885040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNETTE GANSBERG Executive Director 541-274-2902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: OR MD227448) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: OR MD27448) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2017-11-14 |