Individual
CHANCE FAHNDRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
777 MURPHY RD, MEDFORD, OR 97504-8425
(154) 177-2276
Mailing address
777 MURPHY RD, MEDFORD, OR 97504-8425
(154) 177-2276
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
202112433
OR
Other
Enumeration date
12/15/2021
Last updated
12/15/2021
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