Organization
SOUTHERN OREGON AESTHETICS AND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MONIQUE A NOYES F-NP/RNFA (OWNER)
(541) 840-8487
Entity
Organization
Contact information
Practice address
5005 TOLO RD, CENTRAL POINT, OR 97502-9335
(760) 731-0313
(760) 731-0414
Mailing address
5005 TOLO RD, CENTRAL POINT, OR 97502-9335
(760) 731-0313
(760) 731-0414
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200850143NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098000578RN
RN FIRST ASSISTANT
OR
Enumeration date
11/25/2014
Last updated
11/26/2014
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