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General NPI Number Information
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NPI Number | 1528063153
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Entity Type | Organization
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Legal Business Name | I'SOT INC
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Dates
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Enumeration Date | 06/20/2005
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Last Update Date | 09/17/2012
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Provider Practice Location Address
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Address Line | 670 COUNTY ROAD 83
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City | CANBY
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State | CA
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Zip | 96015-9722
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Country | US
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Telephone | 530-233-4641
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Fax | 530-233-4140
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Provider Business Mailing Address
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Address Line | 670 COUNTY ROAD 83
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City | CANBY
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State | CA
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Zip | 96015-9722
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Country | US
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Telephone | 530-233-4641
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Fax | 530-233-4140
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. GRETA J ELLIOTT
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Credential |
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Telephone | 530-233-4641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 230000116
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License Number State | CA
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