NPI | 1124603055 |
---|---|
Other Name | NES GRESHAM |
Entity Type | Organization |
Authorized Contact | THOMAS CHARLES MELILLO Owner 503-245-2420 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric |
Enumeration Date | 2021-03-11 |
Last Update Date | 2021-03-11 |