| NPI | 1801812078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN A MEHLHAFF Executive Member 541-334-3350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2022-09-28 |