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General NPI Number Information
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NPI Number | 1053319376
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Entity Type | Organization
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Legal Business Name | STEVIE TROSPER
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Dates
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Enumeration Date | 07/11/2005
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Last Update Date | 08/04/2008
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Provider Practice Location Address
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Address Line | 1930 CUMBERLAND AVE
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City | MIDDLESBORO
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State | KY
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Zip | 40965-1231
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Country | US
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Telephone | 606-248-9020
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Fax | 606-248-9015
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Provider Business Mailing Address
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Address Line | 1930 CUMBERLAND AVE
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City | MIDDLESBORO
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State | KY
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Zip | 40965-1231
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Country | US
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Telephone | 606-248-9020
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Fax | 606-248-9015
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Authorized Official
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Title or Position | OWNER
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Name | MR. STEVE TROSPER
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Credential |
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Telephone | 606-248-9020
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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 | 258490
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License Number State | KY
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