Individual
PEGGY LEE MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1539 NE F ST, GRANTS PASS, OR 97526
(541) 956-7647
(541) 956-8739
Mailing address
1539 NE F STREET, GRANTS PASS, OR 97526
(541) 956-7647
(541) 956-8739
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
01/02/2007
Last updated
09/17/2008
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