| NPI | 1376921080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS THERON HAMPTON Podiatrist 541-963-0265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: OR DP170092) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OR DP170092) |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: OR DP170092) | |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2015-05-21 |