| NPI | 1649629734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARSON MCKEE CASE Lmt 541-944-5648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: OR 20830) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2016-10-02 |