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EDEN PRACTITIONERS LLC 1376219147

Overview
Name: EDEN PRACTITIONERS LLC Specialty: Substance Use Disorder Rehabilitation Clinic/Center Type of Practice: Organization Provider/Org: Medical School: Graduation year from medical school: Affiliation:
Specialties
Practice Type: Ambulatory Health Care Facilities Classification: Clinic/Center Specialization: Rehabilitation, Substance Use Disorder. Definition of Specialty: Definition to come…
License & NPI
License #(s): , , , , License State(s): , , , ,
Addresses
Practice Location: EDEN PRACTITIONERS LLC,843 E MAIN ST STE 204,MEDFORD,OR,975047137,US Mailing Address: EDEN PRACTITIONERS LLC,843 E MAIN ST STE 204,MEDFORD,OR,975047137,US
Contact #
Practice location phone #: 5413290478 Practice location fax #: 5413149556 Mailing address Phone #: 5413290478 Mailing Address fax #: 5413149556 Authorized official Name/Telephone #:DR., DANE, FICKES, OWNER 5413290478
Misc
Date NPI was obtained: 08/20/2021 Last data data was updated: 08/20/2021 Insurances:

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