Individual
HIROKI IDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
20 NW HOOD PL, BEND, OR 97703-2518
(541) 706-1327
Mailing address
20 NW HOOD PL, BEND, OR 97703-2518
(541) 706-1327
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC179136
OR
Other
Enumeration date
01/19/2017
Last updated
01/19/2017
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