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Organization

DJ TINY RIDERWHEELS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TIMOTHY L THOMPSON SR. (CEO)
(770) 374-4088
Entity
Organization

Contact information

Practice address
622 WOODSTONE RD, LITHONIA, GA 30058-5947
(770) 374-4088
Mailing address
622 WOODSTONE RD, LITHONIA, GA 30058-5947
(770) 374-4088

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
GA

Other

Enumeration date
10/28/2008
Last updated
07/21/2022
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