Organization
BROOKINGS HARBOR FAMILY PRACTICE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH MANUELE (D.O.)
(541) 469-2330
Entity
Organization
Contact information
Practice address
97825 SHOPPING CENTER AVE., BROOKINGS, OR 97415
(541) 469-2330
Mailing address
PO BOX 7529, BROOKINGS, OR 97415-0344
(541) 469-2330
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
19106
OR
Other
Enumeration date
05/10/2007
Last updated
09/15/2007
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