institution
Icco Llc
Primary Care Clinic/Center in Roseburg, Oregon
NPI 1053854208

Icco Llc is a Primary Care Clinic/Center based in Eugene, OR and is specialized in Primary Care. Icco Llc practices in Roseburg, OR. The NPI Number for Icco Llc is 1053854208 and holds a License No. (Oregon).

The current practice location address for Icco Llc is 1740 Nw Goetz Street, Roseburg, OR and can be reached out via phone at 541-672-4885 and via fax at 541-672-4782. You can also correspond with Icco Llc through the mailing address at 1292 HIGH STREET, EUGENE, OR - 97401 (mailing address contact number: 541-228-3865).

Location: 1740 Nw Goetz Street, Roseburg, OR, 97401
institution
Provider Profile Details
NPI Number
1053854208
Provider Name
Icco Llc
Credential
Provider Entity Type
Organization
Address
1740 Nw Goetz Street, Roseburg, OR, 97401
Phone Number
541-672-4885
Fax Number
541-672-4782
Provider Enumeration Date
11/21/2016
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
DP1360 01 OR RR MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
1740 Nw Goetz Street
City
State
Zip
97471
Phone Number
541-672-4885
Fax Number
541-672-4782
person
Provider Business Mailing Address Details
Address
1740 Nw Goetz Street
City
State
Zip
97471
Phone Number
541-672-4885
Fax Number
541-672-4782
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
License No.
()
Definition
Definition to come...
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