Organization
SOUTH UMPQUA INTEGRATED HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIKE SHIRTCLIFF DMD (OWNER/DENTIST)
(541) 680-9028
Entity
Organization
Contact information
Practice address
244 NE DIVISION ST, MYRTLE CREEK, OR 97457-8507
(541) 680-9028
Mailing address
PO BOX 3008, MYRTLE CREEK, OR 97457-0014
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
122300000X
Dentist
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
Other
Enumeration date
04/29/2019
Last updated
04/29/2019
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