| NPI | 1295103810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS ETGES Owner 541-525-6343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: OR 18085) |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2015-09-14 |