| NPI | 1467746065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH HUNT WALDRON Registered Agent 541-740-3340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR MD17598) |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2011-06-01 |