| NPI | 1366826471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETICIA ROMAN Lmt 541-610-7711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: OR 17244) |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2017-02-14 |