Southern Oregon Medical Practice LLC
NPI #1184000549 in Grants Pass, Oregon
Provider Information
- NPI Number
- 1184000549
- Entity Type
- Organization
- Organization Name
- Southern Oregon Medical Practice LLC
- Primary Specialty
- Nurse Practitioner - Family
- Enumeration Date
- Aug 7, 2015
- Last Updated
- Aug 7, 2015
Practice Location
- Address
- 824 UNIT B, ROGUE RIVER HIGHWAY
- City
- Grants Pass
- State
- Oregon
- ZIP Code
- 97527-0000
- Phone
- (541) 244-1261
Authorized Official
- Name
- MR. STEPHEN DANIEL SPALLETTA
- Title
- OWNER
- Phone
- (541) 295-4034
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
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