| NPI | 1407554819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE CARTER Owner 541-280-6201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| Enumeration Date | 2023-02-16 |
| Last Update Date | 2024-03-28 |