# EVERGREEN REGENERATIVE MEDICINE AND REHABILITATION PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003578907
- **Authorized official:** DAVID E HARRIS (PRESIDENT/OWNER)
- **Authorized official phone:** (541) 414-0455

## Contact information

- **Practice address:** 707 MURPHY RD, MEDFORD, OR 97504-8520
- **Practice address phone:** (541) 414-0455
- **Practice address fax:** (541) 414-0450
- **Mailing address:** 707 MURPHY RD STE 101, MEDFORD, OR 97504-8520
- **Mailing address phone:** (541) 414-0455
- **Mailing address fax:** (541) 414-0450

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/07/2021
- **Last updated:** 12/05/2021