| NPI | 1952586869 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL GROUP NEUROLOGY ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | KEENAN B FREEMAN CFO 503-893-6524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2013-08-02 |