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Organization
TABLE ROCK NUTRITION AND DIABETES CLINIC
Active
Organization
TABLE ROCK NUTRITION AND DIABETES CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIAH S SANGER RD (OWNER)
(541) 531-9548
Entity
Organization
Contact information
Practice address
122 E MAIN ST STE 400-110, MEDFORD, OR 97501-6004
(541) 531-9548
Mailing address
122 E MAIN ST STE 400-110, MEDFORD, OR 97501-6004
(541) 531-9548
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
04/14/2025
Last updated
04/14/2025
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