Provider Demographics
NPI:1619160348
Name:SOUTHERN OREGON RESPIRATORY TESTING LLC
Entity Type:Organization
Organization Name:SOUTHERN OREGON RESPIRATORY TESTING LLC
Other - Org Name:O2TESTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:877-883-7862
Mailing Address - Street 1:PO BOX 925
Mailing Address - Street 2:
Mailing Address - City:MERLIN
Mailing Address - State:OR
Mailing Address - Zip Code:97532-0925
Mailing Address - Country:US
Mailing Address - Phone:877-883-7862
Mailing Address - Fax:877-583-7862
Practice Address - Street 1:1215 NE 7TH ST
Practice Address - Street 2:SUITE E-1
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-1450
Practice Address - Country:US
Practice Address - Phone:877-883-7862
Practice Address - Fax:877-583-7862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRT-P-101165722279P1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2279P1004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary DiagnosticsGroup - Single Specialty