Organization
OREGON TLC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROY M. BLACKBURN M.D. (PRESIDENT)
(817) 284-9850
Entity
Organization
Contact information
Practice address
132 E BROADWAY, SUITE 716, EUGENE, OR 97401-3143
(817) 284-9850
(817) 284-3505
Mailing address
132 E BROADWAY, SUITE 716, EUGENE, OR 97401-3143
(817) 284-9850
(817) 284-3505
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD22132
OR
Other
Enumeration date
12/18/2006
Last updated
08/22/2020
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