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General NPI Number Information
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NPI Number | 1093061863
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Entity Type | Organization
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Legal Business Name | KERRY BRAMON REMODELING AND DESIGN
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Dates
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Enumeration Date | 07/31/2012
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Last Update Date | 11/07/2012
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Provider Practice Location Address
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Address Line | 1204 ROGERS ST SUITE G
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City | COLUMBIA
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State | MO
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Zip | 65201-4736
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Country | US
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Telephone | 573-875-0794
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Fax | 573-443-3841
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Provider Business Mailing Address
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Address Line | 1204 ROGERS ST SUITE G
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City | COLUMBIA
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State | MO
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Zip | 65201-4736
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Country | US
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Telephone | 573-875-0794
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Fax | 573-443-3841
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KERRY L. BRAMON
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Credential |
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Telephone | 573-875-0794
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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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 | MO
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