| NPI | 1700999521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES RAY CRISPEN Owner/Physician 541-955-5683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OR DO14538) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2020-08-22 |