| NPI | 1427500784 |
|---|---|
| Former Legal Business Name | GLOW HEALTHCARE FOR WOMEN |
| Entity Type | Organization |
| Authorized Contact | REBECCA L PROVORSE Owner/Physician 971-407-3066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 175F00000X Naturopath (Licence: OR 1375) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: OR AC00861) |
| Enumeration Date | 2016-11-02 |
| Last Update Date | 2016-11-02 |