Organization
SOAM MEDICAL & WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT M KENYON (OWNER)
(541) 291-6910
Entity
Organization
Contact information
Practice address
801 E MAIN ST STE 100, MEDFORD, OR 97504-7169
(541) 779-5235
Mailing address
801 E MAIN ST STE 100, MEDFORD, OR 97504-7169
(541) 779-5235
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
05/31/2024
Last updated
05/31/2024
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