River Rock Family Practice Pc

NPI 1184052136 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1184052136
Enumeration Date 10/29/2013
Last Updated 10/29/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name MASON MASON
Position PRESIDENT
Phone (541) 621-4736
Fax
Practice Location
1833 NEBRASKA AVE
GRANTS PASS OR, 97527-5701, US
Phone (541) 621-4736
Fax
Business Location
1833 NEBRASKA AVE
GRANTS PASS OR, 97527-5701, US
Phone
Fax
Toxanomy
Taxonomy Code 363LF0000X
License State Oregon
License Number 200550153NP
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According to our database, River Rock Family Practice Pc NPI is 1184052136, taxonomy code is 363LF0000X and license number is 200550153NP, license state is located at Oregon. River Rock Family Practice Pc physically located at 1833 Nebraska Ave, Grants Pass OR, 97527-5701. NPI Number 1033115704 has the healthcare provider type.

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1184052136 NPI number is provided on an as is basis without warranty of any kind. 1184052136 is maintained by the National Plan & Provider Enumeration System. The contents of River Rock Family Practice Pc are for informational purposes only.