| Pony Creek Board And Care | |
|
2345 Marion St North Bend OR 97459-2637 | |
| (541) 270-0219 | |
| Not Available |
| Full Name | Pony Creek Board And Care |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 2345 Marion St, North Bend, Oregon |
| Authorized Official Name and Position | Michael Sewitsky (FINANCE DIRECTOR) |
| Authorized Official Contact | 5418588170 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pony Creek Board And Care 3587 Heathrow Way Medford OR 97504-4004 Ph: (541) 858-8170 | Pony Creek Board And Care 2345 Marion St North Bend OR 97459-2637 Ph: (541) 270-0219 |
| NPI Number | 1124534185 |
|---|---|
| Provider Enumeration Date | 12/28/2017 |
| Last Update Date | 12/28/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124534185 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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