NPI | 1811246259 |
---|---|
Entity Type | Organization |
Authorized Contact | BRAD MARSHAL VOLLMER Owner 503-908-1001 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OR 3867) |
Enumeration Date | 2012-08-30 |
Last Update Date | 2012-08-30 |