| NPI | 1225650864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID EDISON HARRIS Owner 541-414-0450 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine |
| Enumeration Date | 2020-05-16 |
| Last Update Date | 2020-05-16 |