Organization
ROGUE INTEGRATIVE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN E HENDERSON ANP-C (DIRERCTOR)
(541) 646-1760
Entity
Organization
Contact information
Practice address
2612 E BARNETT RD, MEDFORD, OR 97504-8344
(541) 773-3191
(541) 779-5647
Mailing address
3361 DARK HOLLOW RD, MEDFORD, OR 97501-4316
(541) 646-1760
(541) 779-5647
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
200950142NP
OR
Other
Enumeration date
11/03/2009
Last updated
11/03/2009
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