Individual
JANIS MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
323 COOPER AVE, WOODLYNNE, NJ 08107-2109
(856) 571-2282
Mailing address
47 LAPIERRE AVE, LAWNSIDE, NJ 08045-1620
(856) 571-2282
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
04/10/2019
Last updated
12/27/2019
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