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Organization

WISE WOMEN CARE ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AUGUSTINE COLEBROOK CPM, LDM (OWNER/DIRECTOR/MIDWIFE)
(541) 772-2291
Entity
Organization

Contact information

Practice address
400 CRATER LAKE AVE, MEDFORD, OR 97504-6808
(541) 772-2291
(541) 245-0417
Mailing address
400 CRATER LAKE AVE, MEDFORD, OR 97504-6808
(541) 772-2291
(541) 245-0417

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
LDM10119128
OR
363LF0000X
Family Nurse Practitioner
200750100NP
OR

Other

Enumeration date
04/04/2012
Last updated
04/04/2012
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