Organization
QUALITY LIFE MEDICAL PRACTICE LLC
Active
Other names
Quality Life Family Practice, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DARLENA PIKE NURSE PRACTITIONER (FNP/CO-OWNER)
(541) 314-4894
Entity
Organization
Contact information
Practice address
1201 NE 7TH ST STE E, GRANTS PASS, OR 97526-1451
(541) 314-4894
(541) 314-4895
Mailing address
1201 NE 7TH ST STE E, GRANTS PASS, OR 97526-1451
(541) 314-4894
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500642365
—
OR
Enumeration date
12/02/2020
Last updated
04/20/2021
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