Individual
MYRNA R MEDFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2428 W REYNOLDS AVE, CENTRALIA, WA 98531-4554
(360) 330-9044
(360) 736-3139
Mailing address
2850 N COUNTRY CLUB RD, TUCSON, AZ 85716-1910
(203) 226-2745
(520) 509-4496
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
0123456789
AZ
Other
Enumeration date
01/08/2020
Last updated
01/04/2022
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