NPI | 1629174495 |
---|---|
Other Name | APPLEGATE VALLEY FAMILY MEDICINE |
Entity Type | Organization |
Authorized Contact | ROGER M FOGG Owner 541-862-2836 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: OR 222705-99) |
Enumeration Date | 2006-09-16 |
Last Update Date | 2019-05-31 |