| NPI | 1649712571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE J FOLSTON Billing Specialist 541-620-8170 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OR MD165076) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2017-01-17 |