| NPI | 1518342344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN FREDRICK WATKINS Owner 541-270-8966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR MD22558) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2015-07-22 |