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
Update your record
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