Organization · Type 2 NPI
Pony Creek Annex, LLC
Ambulatory Surgical Clinic/Center · North Bend, OR
NPI number
1538736459
Active
Practice location
2075 Public Square Court
North Bend, OR 97459-1270
Mailing address
3585 Broadway Ave
North Bend, OR 97459-1251
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Ambulatory Surgical Clinic/Center Primary | 261QA1903X | None listed |
Ambulatory Surgical Clinic/Center: Definition to come...
About NPI 1538736459
Pony Creek Annex, LLC's National Provider Identifier is 1538736459, issued on Jun 9, 2021. The primary taxonomy on file is Ambulatory Surgical Clinic/Center (261QA1903X), and the practice location is in North Bend, OR. The record was last updated on Jun 9, 2021.