NPI | 1366492548 |
---|---|
Doing Business As | WELLSPRING FAMILY PRACTICE |
Entity Type | Organization |
Authorized Contact | JON ERMSHAR President/Provider 541-474-6053 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2006-05-11 |
Last Update Date | 2007-11-26 |