| NPI | 1467934661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANJUANITA CANTU Billing/Credentialing Services Mgr 541-481-7212 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2018-09-04 |