Wise Mountain Medicine Llc
Clinic/Center in Bend, OR(View on Map)
Legal Business Name
Wise Mountain Medicine Llc
NPI Number
1316512049
NPI Type
Organization
Enumeration Date
05/25/2021
Specialties
(Taxonomies)Contact
Information
Purpose
Mailing
Location
Address
2150 NW HILL ST APT 3
335 NE REVERE AVE
City
Bend
Bend
State
OR
OR
Postal Code
97703-1373
97701-4059
Country
US
US
Telephone Number
(970) 406-1019
(541) 238-7285
Authorized Official
Name
Dr. Carlton Kelch
Title or Position
CO-OWNER
Telephone Number
(970) 406-1019
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 05/25/2021
Provider Address
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