Individual
JENESSA BOLENBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3250 HILLCREST PARK DR STE 102, MEDFORD, OR 97504-7684
(541) 773-7409
Mailing address
3250 HILLCREST PARK DR STE 102, MEDFORD, OR 97504-7684
(541) 773-7409
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
10196768
OR
Other
Enumeration date
04/07/2020
Last updated
04/07/2020
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