| NPI | 1659331007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOIS M FONDREN Manager 541-683-0878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: OR MD13772) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2009-10-19 |