NPI | 1134604606 |
---|---|
Doing Business As | LEBANON FAMILY PRACTICE |
Entity Type | Organization |
Authorized Contact | LANCE BRANDON LARGE Medical Director 503-400-6140 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2018-10-01 |
Last Update Date | 2022-06-15 |