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General NPI Number Information
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NPI Number | 1205311479
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Entity Type | Organization
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Legal Business Name | METICULOUS MEDICAL, INC.
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Dates
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Enumeration Date | 10/03/2018
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Last Update Date | 11/16/2018
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Provider Practice Location Address
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Address Line | 672 WEST 11TH STREET SUITE 323
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City | TRACY
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State | CA
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Zip | 95376
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Country | US
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Telephone | 833-638-6331
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Fax | 559-453-0107
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Provider Business Mailing Address
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Address Line | 672 WEST 11TH STREET SUITE 323
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City | TRACY
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State | CA
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Zip | 95376
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Country | US
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Telephone | 833-638-6331
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Fax | 559-453-0107
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JASON JERRY MCCAMEY
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Credential | MS, ATC
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Telephone | 559-593-2451
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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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