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Organization

OPTIMAL HEALTH OF SOUTHERN OREGON, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WENDELL CHARLES HEIDINGER MD (OWNER)
(541) 507-1948
Entity
Organization

Contact information

Practice address
1600 NW 6TH ST SOUTH SUITE, GRANTS PASS, OR 97526
(541) 507-1948
(541) 727-0382
Mailing address
1600 NW 6TH ST SOUTH SUITE, GRANTS PASS, OR 97526
(541) 507-1948
(541) 727-0382

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD18680
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
190932
OR
Enumeration date
09/07/2016
Last updated
04/18/2018
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