| NPI | 1801131404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVONNE SUZANNE FRIED Owner 541-482-3327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: OR MD18034) |
| Enumeration Date | 2012-12-07 |
| Last Update Date | 2012-12-07 |