| NPI | 1952819591 |
|---|---|
| Former Legal Business Name | PEGGY L. MEDINA DBA WELLNESS WARE |
| Entity Type | Organization |
| Authorized Contact | PEGGY LEE MEDINA Owner 541-956-7647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2018-01-17 |
| Last Update Date | 2018-01-17 |