| NPI | 1598783417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD RICO CFO 541-882-6311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2015-10-23 |