MCKENZIE VILLANUEVA

MEDFORD, OR
NPI1124645163
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy171W00000X Contractor
(Licence:   BAP-TA-10200933)
Enumeration Date2020-06-25
Last Update Date2020-06-25
Business Address
MCKENZIE VILLANUEVA
18 MYRTLE ST
MEDFORD, OR 97504-7338
Phone number: 541-301-0522
Mailing Address
MCKENZIE VILLANUEVA
18 MYRTLE ST
MEDFORD, OR 97504-7338
Phone number: 541-301-0522
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