Provider Demographics
NPI:1174868020
Name:BEND OSTEOPATHIC CARE, PC
Entity Type:Organization
Organization Name:BEND OSTEOPATHIC CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMY
Authorized Official - Middle Name:W
Authorized Official - Last Name:LAWRASON-KOBOBEL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:541-706-9985
Mailing Address - Street 1:147 SW SHEVLIN HIXON DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3130
Mailing Address - Country:US
Mailing Address - Phone:541-706-9985
Mailing Address - Fax:541-408-9853
Practice Address - Street 1:147 SW SHEVLIN HIXON DR
Practice Address - Street 2:SUITE 204
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3130
Practice Address - Country:US
Practice Address - Phone:541-706-9985
Practice Address - Fax:541-408-9853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-04
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO157442261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty