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General NPI Number Information
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NPI Number | 1659361202
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Entity Type | Organization
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Legal Business Name | MOBILITY REHAB PRODUCTS, LLC
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Dates
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Enumeration Date | 10/25/2005
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Last Update Date | 11/19/2013
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Provider Practice Location Address
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Address Line | 1106 BUSINESS PARKWAY SOUTH A-1
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City | WESTMINSTER
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State | MD
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Zip | 21157
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Country | US
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Telephone | 410-833-2603
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Fax | 410-833-2640
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Provider Business Mailing Address
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Address Line | 1106 BUSINESS PARKWAY SOUTH A-1
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City | WESTMINSTER
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State | MD
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Zip | 21157
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Country | US
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Telephone | 410-833-2603
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Fax | 410-833-2640
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Authorized Official
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Title or Position | COO
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Name | MR. MARC ALAN MYZAL
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Credential |
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Telephone | 410-833-2603
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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 | 06013861
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License Number State | MD
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