| NPI | 1285964304 |
|---|---|
| Doing Business As | JEFFREY M GONZALES |
| Entity Type | Organization |
| Authorized Contact | JEFFREY M GONZALES Owner/Provider 541-419-6337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2010-01-12 |
| Last Update Date | 2010-01-12 |