| NPI | 1992420194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE VIRAMONTES Owner 541-988-6330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 2086S0129X |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2023-01-27 |