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Organization

TALENT CLINIC, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MAX E TENSCHER FNP (OPERATIONS MEMBER)
(541) 535-9108
Entity
Organization

Contact information

Practice address
312 E MAIN ST, TALENT, OR 97540
(541) 535-9108
(541) 535-8809
Mailing address
PO BOX 422, TALENT, OR 97540-0422
(541) 535-9108
(541) 535-8809

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500668536
OR
Enumeration date
07/25/2013
Last updated
03/26/2014
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