# SOAM MEDICAL & WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922848357
- **Authorized official:** BRENT M KENYON (OWNER)
- **Authorized official phone:** (541) 291-6910

## Contact information

- **Practice address:** 801 E MAIN ST STE 100, MEDFORD, OR 97504-7169
- **Practice address phone:** (541) 779-5235
- **Mailing address:** 801 E MAIN ST STE 100, MEDFORD, OR 97504-7169
- **Mailing address phone:** (541) 779-5235

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/31/2024
- **Last updated:** 05/31/2024