| NPI | 1659470441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA M FISHER Office Coordinator 541-923-5886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: OR MD22835) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-08-22 |