| NPI | 1558515494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY D JACKSON Office Manager 541-344-4168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2014-07-02 |