CENTENNIAL MEDICAL GROUP EAST, LLC
Marriage and Family Therapists at Medical Park Dr, Roseburg, OR

License number
Oregon MD12182
Category
Osteopathic Medicine
Type
Family Medicine
Owner
Name: DONNA KENNEDY
Title: DIRECTOR, BUSINESS SERVICES
Phone: (541) 229-3302
Address
Address
2510 NW Medical Park Dr, Roseburg, OR 97471
National Provider ID: 1235688805
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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CENTENNIAL MEDICAL GROUP EAST, LLC

Roseburg, OR

Industry:
Health/Allied Services
Registration:
Sep 2, 2010
Addresses:
2570 NW Edenbower Blvd, Roseburg, OR 97471 (Physical)
2801 Mercy Dr SUITE 340, Roseburg, OR 97471 (Mailing)
State ID:
71216890
Business type:
DOMESTIC LIMITED LIABILITY COMPANY
Corp Secretary , Presidents:
Erin P. Rice (Nurse Practitioner),Robert L. Dannenhoffer (Principal),Rahul S. Agarwal (Corp Secretary , President)
Agent:
Jason Gray,2801 Mercy Dr SUITE 340, Roseburg, OR 97471 (Physical)

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