Icco, LLC

NPI #1104490887 in Lebanon, Oregon

Provider Information

NPI Number: 1104490887
Entity Type: Organization
Organization Name: Icco, LLC
Primary Specialty: Clinic/Center - Rural Health
Enumeration Date: May 17, 2021
Last Updated: Jun 20, 2022

Practice Location

Address: 3400 COOPERATIVE WAY
City: Lebanon
State: Oregon
ZIP Code: 97355-4063
Phone: (541) 666-3305

Authorized Official

Name: ERICA HAUSER
Title: CFO
Phone: (312) 590-5372

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Rural Health — Rural Health	261QR1300X	Primary

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