| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1437512449 | BOSCH | SAGE | 1003 E MAIN ST # 104 | MEDFORD | OR | 975047448 | ||
| 1417310236 | JUMPING EAGLE | ADRIANNA | 1003 E MAIN ST | MEDFORD | OR | 975047448 | ||
| 1942663968 | OLSON | NATHAN | 1003 E MAIN ST STE 104 | MEDFORD | OR | 975047448 | ||
| 1891149720 | ROCK | PAUL | A | 1003 E MAIN ST STE 104 | MEDFORD | OR | 975047140 | |
| 1679153225 | SHARP | JUSTIN | M | 1003 E MAIN ST STE 104 | MEDFORD | OR | 975047140 |