| NPI | 1417049685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI J JETT Owner/Physician 541-389-0450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: OR MD14733) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2020-08-22 |