National Provider Identifier Database

PEDIATRIC TLC PC
Pediatrics


Contact Information

PEDIATRIC TLC PC
1819 NEBRASKA AVE
GRANTS PASS, OR97527-5701
Phone: 541-479-2411
Fax:
Website:
Specialty Taxonomy Code
* Pediatrics 363LP0200X

* Indicates primary specialty

NPI Profile & details for PEDIATRIC TLC PC

NPI Number 1548930464
Legal business name
LBN
PEDIATRIC TLC PC
Authorized official YVONNE MARTENIA - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 09/14/2021
Last updated 08/25/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for PEDIATRIC TLC PC

There are currently no reviews for PEDIATRIC TLC PC


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