| NPI | 1801053012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA L KOPP Office Manager 541-389-3329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OR 2340ATl) |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2008-05-16 |