| NPI | 1881186336 |
|---|---|
| Doing Business As | PACIFIC SPORTS AND SPINE |
| Entity Type | Organization |
| Authorized Contact | LESLIE REA Practice Manager 541-743-9003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OR MD27887) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OR MD28629) |
| 363A00000X Physician Assistant (Licence: OR PA00800) | |
| 363A00000X Physician Assistant (Licence: OR PA00420) | |
| 363A00000X Physician Assistant (Licence: OR PA152998) | |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2023-11-06 |