Organization
VENTANA WELLNESS, PC
Active
Other names
Southern Oregon Health and Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRANK RICHARD NOODLEMAN MD (OWNER)
(541) 773-9772
Entity
Organization
Contact information
Practice address
3156 STATE STREET, MEDFORD, OR 97504-8450
(541) 773-9772
(541) 773-1113
Mailing address
3156 STATE STREET, MEDFORD, OR 97504-8450
(541) 773-9772
(541) 773-1113
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
06-00024661
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287179
—
OR
Enumeration date
07/10/2006
Last updated
11/16/2015
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