| NPI | 1356433510 |
|---|---|
| Doing Business As | PROVIDENCE PEDIATRIC SPECIALTIES 2 |
| Entity Type | Organization |
| Authorized Contact | MITCHELL NEYHART CFO 503-574-9840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2011-10-07 |