Earth Song Medical Practice Llc | |
18173 Redwood Hwy Selma OR 97538 | |
(541) 237-4470 | |
Not Available |
Full Name | Earth Song Medical Practice Llc |
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Speciality | Clinic/center - Primary Care |
Location | 18173 Redwood Hwy, Selma, Oregon |
Authorized Official Name and Position | Michael G Pruner (OWNER/MANAGER) |
Authorized Official Contact | 5412374470 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Earth Song Medical Practice Llc 4567 Deer Creek Rd Selma OR 97538-9612 Ph: (541) 237-4470 | Earth Song Medical Practice Llc 18173 Redwood Hwy Selma OR 97538 Ph: (541) 237-4470 |
NPI Number | 1912462144 |
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Provider Enumeration Date | 02/01/2019 |
Last Update Date | 02/01/2019 |
Identifier | Type | State | Issuer |
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1912462144 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |