# VENTANA WELLNESS, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southern Oregon Health and Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720012339
- **Authorized official:** MR. FRANK RICHARD NOODLEMAN MD (OWNER)
- **Authorized official phone:** (541) 773-9772

## Contact information

- **Practice address:** 3156 STATE STREET, MEDFORD, OR 97504-8450
- **Practice address phone:** (541) 773-9772
- **Practice address fax:** (541) 773-1113
- **Mailing address:** 3156 STATE STREET, MEDFORD, OR 97504-8450
- **Mailing address phone:** (541) 773-9772
- **Mailing address fax:** (541) 773-1113

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 06-00024661 | OR | Yes |

## Other

- **Enumeration date:** 07/10/2006
- **Last updated:** 11/16/2015