MCKENZIE VILLANUEVA

Contractor

Active Individual
NPI: 1124645163

Practice Address

18 MYRTLE ST
Medford, OR 97504

Phone: (541) 301-0522

Specialties

Specialty Code Primary License
Contractor 171W00000X Yes BAP-TA-10200933 ()

Frequently Asked Questions

NPI 1124645163 is the National Provider Identifier for MCKENZIE VILLANUEVA, a Contractor provider located in Medford, OR. This NPI was enumerated on June 25, 2020.
MCKENZIE VILLANUEVA practices at 18 MYRTLE ST, Medford, OR 97504.

Quick Facts

NPI
1124645163
Type
Individual
Enumerated
Jun 25, 2020
Last Updated
Jun 25, 2020

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