Organization
WENDY A. WIGMORE
Active
Other names
Jackson Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY ANN WIGMORE RN (OWNER)
(707) 446-7014
Entity
Organization
Contact information
Practice address
480 REDWOOD ST STE 44, VALLEJO, CA 94590-2958
(707) 644-4170
(707) 644-4163
Mailing address
480 REDWOOD ST STE 44, VALLEJO, CA 94590-2958
(707) 644-4170
(707) 644-4163
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PENDING
CA
Other
Enumeration date
01/22/2007
Last updated
04/19/2009
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