| Lake Wound Clinic | |
|
670 County Rd 83 Canby CA 96015 | |
| (541) 947-7299 | |
| (541) 947-3339 |
| Full Name | Lake Wound Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 670 County Rd 83, Canby, California |
| Authorized Official Name and Position | Gordon Ensley (CEO) |
| Authorized Official Contact | 5419472114 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Wound Clinic 700 S J St Lakeview OR 97630-1623 Ph: (541) 947-7299 | Lake Wound Clinic 670 County Rd 83 Canby CA 96015 Ph: (541) 947-7299 |
| NPI Number | 1326187261 |
|---|---|
| Provider Enumeration Date | 02/06/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326187261 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 14-0896 (Oregon) | Primary |
Canby Family Practice Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 670 County Road 83, Canby, CA 96015 Phone: 530-233-4641 Fax: 530-233-2830 | |
Canby Family Practice Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 670 County Road 83, Canby, CA 96015 Phone: 530-233-4641 Fax: 530-233-4140 |