| NPI | 1659524825 |
|---|---|
| Doing Business As | PROV PEDIATRIC GENETICS |
| Entity Type | Organization |
| Authorized Contact | MITCHELL S NEYHART CFO 503-574-9840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2010-04-16 |