| NPI | 1912349580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK PETERSON Doctor 541-770-5007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: OR MD18861) |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2013-09-17 |