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Suppliers Durable Medical Equipment & Medical Supplies

Provider NPI: 1902812407

Organization Information:
Organization is not Subpart
Authorized Official:  DONET CHRISTOPHER MAIN  OWNER  660-385-1006

Practice Location:
1706 PROSPECT DR  MACON, MO 63552-2615 US
Tel: 660-385-1006  Fax: 660-385-1028

Business Mailing Address:
Tel: 314-989-0300  Fax: 314-810-1399

NPI Information:
NPI: 1902812407
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Durable Medical Equipment & Medical Supplies
Orthopaedic Surgery

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 207XS0114X





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