| NPI | 1467514737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE FRANCES DEVOE President, Shareholder S Corp 541-889-0878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2020-08-22 |