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General NPI Number Information
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NPI Number | 1043030232
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Entity Type | Organization
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Legal Business Name | BRENT R. WENDEL, DPM, LLC
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Dates
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Enumeration Date | 10/14/2024
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 900 NW MT WASHINGTON DR STE 205
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City | BEND
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State | OR
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Zip | 97703-6719
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Country | US
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Telephone | 541-246-3577
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Fax |
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Provider Business Mailing Address
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Address Line | 2221 NW HIGH LAKES LOOP
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City | BEND
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State | OR
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Zip | 97703-6973
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Country | US
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Telephone | 206-250-4320
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRENT ROBERT WENDEL
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Credential | DPM
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Telephone | 206-250-4320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0000X
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Taxonomy Name | Sports Medicine Podiatrist
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License Number |
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License Number State |
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