Organization
KIDS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA M ALLARD (OFFICE MANAGER)
(541) 772-5548
Entity
Organization
Contact information
Practice address
691 MURPHY RD STE 209, MEDFORD, OR 97504-4311
(541) 772-5548
(541) 245-0919
Mailing address
691 MURPHY RD STE 209, MEDFORD, OR 97504-4311
(541) 772-5548
(541) 245-0919
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
18968
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
218117
—
OR
Enumeration date
01/29/2008
Last updated
01/29/2008
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