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General NPI Number Information
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NPI Number | 1659966596
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Entity Type | Organization
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Legal Business Name | SURGEON'S CHOICE, LLC
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Dates
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Enumeration Date | 03/03/2021
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Last Update Date | 01/06/2022
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Provider Practice Location Address
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Address Line | 1555 1ST ST
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City | COLUMBIA CITY
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State | OR
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Zip | 97018-9505
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Country | US
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Telephone | 503-702-6438
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Fax |
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Provider Business Mailing Address
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Address Line | 1555 1ST ST
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City | COLUMBIA CITY
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State | OR
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Zip | 97018-9505
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Country | US
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Telephone | 503-702-6438
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | ZACHARY MEILING
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Credential | CSFA
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Telephone | 503-702-6438
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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