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General NPI Number Information
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NPI Number | 1750874764
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Entity Type | Organization
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Legal Business Name | OZARK ACTION, INC.
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Dates
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Enumeration Date | 06/13/2018
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Last Update Date | 06/13/2018
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Provider Practice Location Address
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Address Line | 710 E MAIN ST
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City | WEST PLAINS
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State | MO
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Zip | 65775-3307
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Country | US
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Telephone | 417-256-6147
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Fax | 417-255-2967
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Provider Business Mailing Address
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Address Line | 710 E MAIN ST
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City | WEST PLAINS
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State | MO
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Zip | 65775-3307
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Country | US
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Telephone | 417-256-6147
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Fax | 417-255-2906
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. BRYAN ADCOCK
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Credential |
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Telephone | 417-256-6147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number |
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License Number State |
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