Healthcare Provider Details
I. General information
NPI: 1760308779
Provider Name (Legal Business Name): JR WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
534 WASHINGTON ST
ASHLAND OR
97520-1682
US
IV. Provider business mailing address
534 WASHINGTON ST
ASHLAND OR
97520-1682
US
V. Phone/Fax
- Phone: 541-227-3282
- Fax:
- Phone: 541-227-3282
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JEREMY
ROTHENBERG
Title or Position: OWNER
Credential: L.AC.
Phone: 510-409-4942