Organization
AUTONOMIC INNOVATIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT RICHARD JOHANSEN (COO)
(503) 780-9221
Entity
Organization
Contact information
Practice address
6464 SW BORLAND RD, STE C3, TUALATIN, OR 97062-8876
(971) 252-6411
(971) 252-6412
Mailing address
6464 SW BORLAND RD, STE C3, TUALATIN, OR 97062-8876
(971) 252-6411
(971) 252-6412
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
01/08/2016
Last updated
01/08/2016
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