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Organization

THE WELLNESS CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIM D HAMMER (OFFICE MANAGER)
(541) 957-5750
Entity
Organization

Contact information

Practice address
2395 NW STEWART PKWY, ROSEBURG, OR 97470-5653
(541) 957-5750
(541) 957-5766
Mailing address
2395 NW STEWART PARKWAY, ROSEBURG, OR 97470
(541) 957-5750
(541) 957-5766

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD21306
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
287168
OR
Enumeration date
03/13/2008
Last updated
03/13/2008
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