Innovative Medical Supply, Llc

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NPI Provider: 1679570121
Contact Name: Berry K Brian
Position: Member
Phone: (405) 799-8855

Innovative Medical Supply, Llc Information:

Innovative Medical Supply, Llc organization have npi 1679570121, taxonomy code is 332B00000X with license number is J4442 in . This Business address located in 1501 SE 4th St, Moore, OK 73160 Oklahoma. Get directions of Innovative Medical Supply, Llc.

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Practice Location
Address: 1501 SE 4th St, Moore, OK 73160
Phone: (405) 799-8855

Business Location

Address: 1501 SE 4th St, Moore, OK 73160

Phone: (405) 799-8855

Fax: (405) 799-8860

Taxonomy

Taxonomy Code: 332B00000X

License Number: J4442

License Number of State: TX

Primary Taxonomy Switch: Y

Enumeration Date: 6/30/2005

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