Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 1194 | OR |
NPI | 1033289772 |
---|---|
Provider Name | Dr. Michelle Renee Homer |
First Address | Central Point, OR 97502-2069 |
Second Address | Central Point, OR 97502-2069 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 08/07/2007 |