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General NPI Number Information
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NPI Number | 1669092003
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Entity Type | Organization
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Legal Business Name | JMS CUSTOM HOMES, LLC
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Dates
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Enumeration Date | 04/24/2020
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Last Update Date | 04/24/2020
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Provider Practice Location Address
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Address Line | 6035 CULLIGAN WAY
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City | MINNETONKA
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State | MN
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Zip | 55345-5918
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Country | US
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Telephone | 952-949-3630
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Fax |
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Provider Business Mailing Address
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Address Line | 6035 CULLIGAN WAY
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City | MINNETONKA
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State | MN
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Zip | 55345-5918
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Country | US
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Telephone | 952-949-3630
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Fax |
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Authorized Official
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Title or Position | SALES AND MARKETING DIRECTOR
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Name | CHARLES ARNOLD RYAN
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Credential |
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Telephone | 612-290-4333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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