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Organization
PACIFIC PLASTIC SURGERY PC
Active
Organization
PACIFIC PLASTIC SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LOIS M FONDREN MBA (MANAGER)
(541) 683-0878
Entity
Organization
Contact information
Practice address
743 COUNTRY CLUB RD, EUGENE, OR 97401-6019
(541) 683-0878
(541) 683-5206
Mailing address
743 COUNTRY CLUB RD, EUGENE, OR 97401-6019
(541) 683-0878
(541) 683-5206
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
MD13772
OR
Other
Enumeration date
03/27/2006
Last updated
10/19/2009
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