| NPI | 1619107695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA CARRIGAN Lead Billing Specialist 541-773-9772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: OR 3687) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2022-03-24 |