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Organization
CENTRAL OREGON SPINE AND SPORTS, LLC
Active
Organization
CENTRAL OREGON SPINE AND SPORTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY M BOOHER BA (ADMINISTRATOR)
(541) 420-4833
Entity
Organization
Contact information
Practice address
2115 NE WYATT CT, SUITE 101, BEND, OR 97701-7678
(541) 420-4833
(541) 228-3670
Mailing address
2115 NE WYATT CT, SUITE 101, BEND, OR 97701-7678
(541) 420-4833
(541) 228-3670
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD152056
OR
Other
Enumeration date
02/03/2017
Last updated
02/03/2017
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