NPI | 1356854830 |
---|---|
Entity Type | Organization |
Authorized Contact | STACY RAE CAPPADONA Registered Dietitian 541-955-2582 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
Enumeration Date | 2017-11-07 |
Last Update Date | 2017-11-07 |