Organization
WELLSPRING CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BAJE THIBODEAUX (OFFICE MANAGER)
(541) 902-8860
Entity
Organization
Contact information
Practice address
1845 HIGHWAY 126 STE H, FLORENCE, OR 97439-9626
(541) 902-8860
Mailing address
PO BOX 2746, FLORENCE, OR 97439-0165
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/02/2017
Last updated
08/02/2017
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