Organization
KALISTA WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WENDY PENELOPE GREEN N.D. (OWNER / DOCTOR)
(541) 779-0100
Entity
Organization
Contact information
Practice address
18 MYRTLE ST, MEDFORD, OR 97504-7471
(541) 779-0100
(541) 779-0107
Mailing address
18 MYRTLE ST, MEDFORD, OR 97504-7471
(541) 779-0100
(541) 779-0107
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
—
—
Other
Enumeration date
04/08/2016
Last updated
08/02/2017
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