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VETERANS AFFAIRS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LAURA HACKETT MSOTR/L (PHYSICAL MEDICINE AND REHAB)
(541) 826-2111
Entity
Organization

Contact information

Practice address
8495 CRATER LAKE HWY, WHITE CITY, OR 97503-3011
(541) 826-2111
Mailing address
8495 CRATER LAKE HWY, WHITE CITY, OR 97503-3011

Taxonomy

Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
09277
OR

Other

Enumeration date
08/03/2016
Last updated
08/03/2016
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