Organization
SKY LAKES MEDICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD E RICO (VP)
(541) 274-6150
Entity
Organization
Contact information
Practice address
2621 CROSBY AVE, KLAMATH FALLS, OR 97603-5726
(541) 274-6406
(541) 274-6711
Mailing address
2865 DAGGETT AVE, KLAMATH FALLS, OR 97601-1106
(541) 274-6221
(541) 274-6247
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0700001687
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152371
—
OR
05
—
ZZR20101F
—
OR
Enumeration date
01/16/2007
Last updated
11/10/2009
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