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General NPI Number Information
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NPI Number | 1982835880
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Entity Type | Organization
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Legal Business Name | SUSTAINABLE ENTERPRISES INC
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Dates
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Enumeration Date | 07/27/2009
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Last Update Date | 07/27/2009
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Provider Practice Location Address
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Address Line | 725 SE MAIN ST STE A
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City | ROSEBURG
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State | OR
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Zip | 97470-3938
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Country | US
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Telephone | 541-673-3276
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Fax | 541-673-2831
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Provider Business Mailing Address
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Address Line | 725 SE MAIN ST STE A
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City | ROSEBURG
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State | OR
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Zip | 97470-3938
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Country | US
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Telephone | 541-673-3276
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Fax | 541-673-2831
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. LAUREN KAY SCHROEDER
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Credential | D.C.
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Telephone | 541-673-3276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 28-2306
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License Number State | OR
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