| NPI | 1104930833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONJA C BRYANT Owner 541-883-1147 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: OR RP-0000892-CS) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2008-07-15 |