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Organization
IMPAKT LLC
Active
Organization
IMPAKT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIN NOEL ASHLEY (CEO)
(727) 492-5141
Entity
Organization
Contact information
Practice address
2636 W GRAND RESERVE CIR, #927, CLEARWATER, FL 33759-4903
(727) 492-5141
Mailing address
PO BOX 4535, CLEARWATER, FL 33758-4535
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
10/23/2009
Last updated
10/23/2009
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