| NPI | 1447561626 |
|---|---|
| Doing Business As | PROVIDENCE CLINICAL GENETICS - CHILD CENTER |
| Entity Type | Organization |
| Authorized Contact | MITCHELL S NEYHART CFO 503-574-9840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2010-06-23 |