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Organization
WILD ROSE MEDICAL CLINIC PC
Active
Organization
WILD ROSE MEDICAL CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN CORDES MD (PRESIDENT)
(541) 686-4153
Entity
Organization
Contact information
Practice address
401 E 10TH AVE, SUITE 250, EUGENE, OR 97401-3317
(541) 686-4153
(541) 686-3468
Mailing address
401 E 10TH AVE, SUITE 250, EUGENE, OR 97401-3317
(541) 686-4153
(541) 686-3468
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16009
OR
Other
Enumeration date
01/08/2007
Last updated
10/10/2007
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