| NPI | 1194010116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN PEARCE Director Of Medical Services 541-966-0508 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X (Licence: OR 201150057) |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2011-06-17 |