Healthcare Provider Details
I. General information
NPI: 1033970926
Provider Name (Legal Business Name): EZ ABLE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/18/2024
Last Update Date: 01/18/2024
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7047 WOLVERINE VIEW DR
WILLIAMSBURG MI
49690-9290
US
IV. Provider business mailing address
801 S GARFIELD AVE # 130A
TRAVERSE CITY MI
49686-3429
US
V. Phone/Fax
- Phone: 877-392-2531
- Fax:
- Phone: 877-392-2531
- Fax: 313-263-6261
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JUSTIN
MATTIS
Title or Position: LEAD INSTALLER
Credential: ELEVATOR JOURNEYMAN
Phone: 231-620-3097