Organization
SOUTHERN OREGON HBOT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE MAO NP (MEDICAL DIRECTOR)
(541) 479-1289
Entity
Organization
Contact information
Practice address
1663 WILLIAMS HWY, GRANTS PASS, OR 97527-5699
(541) 479-1289
Mailing address
1663 WILLIAMS HWY, GRANTS PASS, OR 97527-5699
(541) 479-1289
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
06/24/2015
Last updated
02/05/2024
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