Organization
CLINIC FOR DERMATOLOGY & WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH JOHN ATZENBECK (CHIEF EXECUTIVE OFFICER)
(541) 200-2777
Entity
Organization
Contact information
Practice address
2924 SISKIYOU BLVD STE 200, MEDFORD, OR 97504-6462
(541) 200-2793
Mailing address
2924 SISKIYOU BLVD STE 200, MEDFORD, OR 97504-6462
(541) 200-2777
(541) 214-2575
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/26/2016
Last updated
06/19/2021
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