| NPI | 1710256839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN DEA BIDLEMAN Bussiness Manager 541-884-0639 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: OR MDO8423) |
| Enumeration Date | 2011-12-19 |
| Last Update Date | 2011-12-19 |