MOUNTAIN WEST DERM - BLACKHART PLLC

ROSEBURG, OR
NPI1891467577
Entity TypeOrganization
Authorized ContactJEFFREY B SHACKELTON
Owner
775-283-4086
Organization Subpart ?No
Primary Taxonomy207N00000X Dermatology
Enumeration Date2021-10-01
Last Update Date2021-10-04
Business Address
MOUNTAIN WEST DERM - BLACKHART PLLC
341 NW MEDICAL LOOP STE 110
ROSEBURG, OR 97471-5546
Phone number: 541-440-2165
Mailing Address
MOUNTAIN WEST DERM - BLACKHART PLLC
341 NW MEDICAL LOOP STE 110
ROSEBURG, OR 97471-5546
Phone number:
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