Organization
TRILLIUM WATERBIRTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUGUSTINE COLEBROOK CPM (OWNER)
(541) 772-2291
Entity
Organization
Contact information
Practice address
400 CRATER LAKE AVE, MEDFORD, OR 97504-6808
(541) 772-2291
(541) 245-0417
Mailing address
400 CRATER LAKE AVE, MEDFORD, OR 97504-6808
(541) 772-2291
(541) 245-0417
Taxonomy
Speciality
Code
Description
License number
State
261QB0400X
Birthing Clinic/Center
Primary
07-1611
OR
Other
Enumeration date
07/01/2011
Last updated
07/01/2011
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