Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Ambulatory Surgical |
261QA1903X | 49 | Ambulatory Surgical Center |
| NPI # | 1063635506 |
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| LBN Legal business name | DESCHUTES EYE CLINIC INC | ||||||||||||||||||||
| Authorized official | OLI TRAUSTASON - (PRESIDENT) | ||||||||||||||||||||
| Entity | Organization | ||||||||||||||||||||
| Organization subpart 1 | No | ||||||||||||||||||||
| Enumeration date | 04/11/2007 | ||||||||||||||||||||
| Last updated | 07/22/2020 - About 6 years ago | ||||||||||||||||||||
| Identifiers |
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