Organization
REESE FAMILY PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RIK LARSON (PRCTICE ADMINISTRATOR)
(541) 255-3905
Entity
Organization
Contact information
Practice address
1755 COBURG RD, BLDG 6B, EUGENE, OR 97401-4982
(541) 255-3905
(541) 357-5527
Mailing address
PO BOX 40386, EUGENE, OR 97404-0060
(541) 255-0395
(541) 357-5527
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD17594
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044854
—
OR
Enumeration date
09/09/2015
Last updated
10/02/2015
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