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General NPI Number Information
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NPI Number | 1770445454
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Entity Type | Organization
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Legal Business Name | EUGENE ELECTROLYSIS LLC
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 3575 DONALD ST STE 110
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City | EUGENE
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State | OR
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Zip | 97405-4753
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Country | US
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Telephone | 541-248-4984
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Fax |
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Provider Business Mailing Address
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Address Line | 3575 DONALD ST STE 110
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City | EUGENE
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State | OR
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Zip | 97405-4753
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Country | US
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Telephone | 541-248-4984
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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 | ANTHONY ARCTURUS ODYSSEUS KANNING
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Credential | LE
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Telephone | 541-248-4984
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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