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General NPI Number Information
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NPI Number | 1336272475
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Entity Type | Organization
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Legal Business Name | DIABETES CONTROL CENTER INC
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 11/16/2009
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Provider Practice Location Address
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Address Line | 702 LEBO BLVD STE B
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City | BREMERTON
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State | WA
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Zip | 98310-3370
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Country | US
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Telephone | 360-479-8881
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Fax | 360-479-8882
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Provider Business Mailing Address
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Address Line | 702 LEBO BLVD STE B
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City | BREMERTON
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State | WA
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Zip | 98310-3370
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Country | US
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Telephone | 360-479-8881
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Fax | 360-479-8882
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Authorized Official
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Title or Position | BOARD CERTIFIED PEDORTHIST
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Name | WILLARD HAWKINS BAKER
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Credential | C PED
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Telephone | 360-479-8881
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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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