Organization
CORVALLIS CLINIC PC
Active
Parent organization
CORVALLIS CLINIC PC
Other names
Corvallis Clinic Physical Therapy Heritage Mall DME only
Organization subpart
Yes
Provider details
NPI number
Legal business name
CORVALLIS CLINIC PC
Authorized official
JAMES KAECH (CHIEF EXECUTIVE OFFICER)
(541) 754-1374
Entity
Organization
Contact information
Practice address
1815 14TH AVE SE, ALBANY, OR 97322-8502
(541) 754-1265
Mailing address
444 NW ELKS DR, CORVALLIS, OR 97330-3745
(541) 754-1374
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/13/2023
Last updated
01/25/2024
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