| NPI | 1235384918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL JOSEPH RUDINSKY President 541-302-9229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OR TO460) |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2008-11-24 |