Organization
LIFESTYLE MEDICINE OF CENTRAL OREGON, PC
Active
Organization
LIFESTYLE MEDICINE OF CENTRAL OREGON, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY HUNTSMAN MD (OWNER)
(541) 291-9960
Entity
Organization
Contact information
Practice address
497 SW CENTURY DR, SUITE 120, BEND, OR 97702-1167
(541) 291-9960
(541) 291-9961
Mailing address
497 SW CENTURY DR, SUITE 120, BEND, OR 97702-1167
(541) 291-9960
(541) 291-9961
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
MD17360
OR
Other
Enumeration date
08/03/2012
Last updated
04/16/2013
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