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General NPI Number Information
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NPI Number | 1740206150
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Entity Type | Organization
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Legal Business Name | KTL&C, LLC
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 10/12/2018
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Provider Practice Location Address
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Address Line | 1845 W 25TH ST STE B
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City | YUMA
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State | AZ
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Zip | 85364-6926
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Country | US
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Telephone | 928-344-9301
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Fax | 928-726-6168
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Provider Business Mailing Address
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Address Line | 1845 W 25TH ST
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City | YUMA
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State | AZ
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Zip | 85364-6929
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Country | US
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Telephone | 928-344-9301
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Fax | 928-726-6168
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Authorized Official
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Title or Position | OWNER
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Name | KATHERINE P SCHOLLE
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Credential |
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Telephone | 928-344-9301
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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 | 20050753
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License Number State | AZ
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