| NPI | 1790490035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE PATRICK TRACEY Member 541-206-2271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171100000X Acupuncturist |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2023-01-20 |
| Last Update Date | 2024-05-08 |