Provider Demographics
NPI:1629176367
Name:SOUTHERN OREGON SLEEP CENTER INC
Entity Type:Organization
Organization Name:SOUTHERN OREGON SLEEP CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:GEOFF
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ZANOTTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-469-2792
Mailing Address - Street 1:16289 HIGHWAY 101 S
Mailing Address - Street 2:UNIT D
Mailing Address - City:BROOKINGS
Mailing Address - State:OR
Mailing Address - Zip Code:97415-8404
Mailing Address - Country:US
Mailing Address - Phone:541-469-2792
Mailing Address - Fax:
Practice Address - Street 1:16289 HIGHWAY 101 S
Practice Address - Street 2:UNIT D
Practice Address - City:BROOKINGS
Practice Address - State:OR
Practice Address - Zip Code:97415-8404
Practice Address - Country:US
Practice Address - Phone:541-469-2792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory