| NPI | 1407055437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL D REICHERTER President 541-672-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207NI0002X Dermatology Clinical & Laboratory Dermatological Immunology (Licence: OR MD23536) |
| Additional Taxonomies | 207NP0225X Dermatology Pediatric Dermatology (Licence: OR MD23536) |
| 207NS0135X Dermatology Procedural Dermatology (Licence: OR MD23536) | |
| 207N00000X Dermatology (Licence: OR MD23536) | |
| 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: OR MD23536) | |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2016-02-15 |