| NPI | 1679395552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH E ZIMMERMAN Owner 541-912-1295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-10-30 |
| Last Update Date | 2024-10-30 |