Organization
RENEW WOMANCARE LLC
Active
Other names
Renew Clinic & Spa
Organization subpart
No
Provider details
NPI number
Authorized official
DAN D KORT M.D (MEMBER/OWNER)
(541) 994-8194
Entity
Organization
Contact information
Practice address
2937 NW HIGHWAY 101, UNIT A, LINCOLN CITY, OR 97367-4442
(541) 614-0314
Mailing address
PO BOX 827, NEOTSU, OR 97364-0827
(541) 614-0314
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD18043
OR
Other
Enumeration date
12/01/2010
Last updated
06/29/2012
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