| NPI | 1821225103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY L LAFFERTY Owner, Provider 541-390-4361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: OR 979838) |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2009-06-15 |