Provider Demographics
NPI:1720331994
Name:WENDY WEINTROB INC
Entity Type:Organization
Organization Name:WENDY WEINTROB INC
Other - Org Name:GLOW ACUPUNCTURE AND NATUROPATHIC MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINTROB
Authorized Official - Suffix:
Authorized Official - Credentials:ND, LAC
Authorized Official - Phone:541-312-9838
Mailing Address - Street 1:701 NW ARIZONA AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-3298
Mailing Address - Country:US
Mailing Address - Phone:541-312-9838
Mailing Address - Fax:541-312-9839
Practice Address - Street 1:701 NW ARIZONA AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-3298
Practice Address - Country:US
Practice Address - Phone:541-312-9838
Practice Address - Fax:541-312-9839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty