Organization
CHILOQUIN FAMILY PRACTICE INC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE LEE COHEN M.D. (OWNER)
(541) 783-3412
Entity
Organization
Contact information
Practice address
2825 RANCH RD, CHILOQUIN, OR 97624-5749
(541) 783-3412
(541) 783-3412
Mailing address
PO BOX 331, CHILOQUIN, OR 97624-0331
(541) 783-3412
(541) 783-3412
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD18099
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287928
—
OR
Enumeration date
05/13/2009
Last updated
05/13/2009
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