| NPI | 1750717054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARI CORBET-OWEN District Manager 707-246-0346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: OR Rph 0013774) |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2013-09-18 |