| NPI | 1972813962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLEG MAKSIMOV President 503-915-9217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 261QP3300X Clinic/Center Pain (Licence: OR MD 28526) |
| 261QP3300X Clinic/Center Pain (Licence: WA MD60054432) | |
| Enumeration Date | 2010-10-08 |
| Last Update Date | 2021-05-23 |