| NPI | 1578865275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONA MYNNEL TARA Owner 541-244-2292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: OR MD15235) |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2013-12-12 |