| NPI | 1629920442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARISSA STULTS VP Of Billing And Contracting 541-930-8545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2026-02-12 |
| Last Update Date | 2026-07-23 |