Mavie Llc | |
1220 Yoke Rd La Pine OR 97739-8981 | |
(864) 905-7900 | |
(864) 878-1528 |
Full Name | Mavie Llc |
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Speciality | Family Medicine |
Location | 1220 Yoke Rd, La Pine, Oregon |
Authorized Official Name and Position | Ravikumar Patel (PARTNER) |
Authorized Official Contact | 8649057900 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Mavie Llc 700 Hendricks Rd Pickens SC 29671-9334 Ph: (864) 878-1528 | Mavie Llc 1220 Yoke Rd La Pine OR 97739-8981 Ph: (864) 905-7900 |
NPI Number | 1366270365 |
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Provider Enumeration Date | 07/23/2024 |
Last Update Date | 10/14/2024 |
Certification Date | 10/14/2024 |
Identifier | Type | State | Issuer |
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1366270365 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
207Q00000X | Family Medicine | (* (Not Available)) | Primary |