Most Relevant Information
Provider Data
| NPI Number: | 1003277211 |
| Provider Name: | CARRYL VILLANUEVA |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/15/2016 |
| Last Updated: | 03/15/2016 |
Provider Practice Location
3397 DELTA WATERS RD
MEDFORD
OR
975045852
Practice Location Phone/Fax
| Phone: | 5417724648 |
| Fax: | 5417342410 |
Provider Mailing Location
3397 DELTA WATERS RD
MEDFORD
OR
975045852
Provider Mailing Phone/Fax
| Phone: | 5417724648 |
| Fax: | 5417342410 |