Organization
THE VISAGE OF BEAUTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CESAR PONCE (MANAGER)
(561) 381-1704
Entity
Organization
Contact information
Practice address
945 TOWN CENTRE DR STE B, MEDFORD, OR 97504-6190
(561) 381-1704
Mailing address
945 TOWN CENTRE DR STE B, MEDFORD, OR 97504-6190
(561) 381-1704
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/20/2026
Last updated
04/20/2026
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