| NPI | 1790295228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY J. CLARKE Owner 541-786-2321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OR DP00283) |
| Additional Taxonomies | 213ES0131X (Licence: OR DP00283) |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2023-03-07 |