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General NPI Number Information
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NPI Number | 1013394873
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Entity Type | Organization
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Legal Business Name | ADAPTIVE MODIFICATIONS LLC
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Dates
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Enumeration Date | 04/30/2015
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Last Update Date | 04/30/2015
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Provider Practice Location Address
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Address Line | 6710 VIRGINIA PKWY STE 215-70
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City | MCKINNEY
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State | TX
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Zip | 75071-5514
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Country | US
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Telephone | 972-754-7103
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Fax | 214-592-0860
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Provider Business Mailing Address
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Address Line | 6710 VIRGINIA PKWY STE 215-70
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City | MCKINNEY
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State | TX
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Zip | 75071-5514
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Country | US
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Telephone | 972-754-7103
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Fax | 214-592-0860
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPY CONSULTANT
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Name | MR. JAMES BOREN
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Credential | COTA
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Telephone | 972-754-7103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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