| NPI | 1417035031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN V ALLCOTT Owner 541-868-1876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: OR MD11435) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: OR MD16571) |
| 261Q00000X Clinic/Center (Licence: OR MD08934) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2018-10-09 |