| NPI | 1841879509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD CLARK CULLEN President 541-727-8972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2023-04-25 |