Organization
POWERCHAIRS PLUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VIC BERNARD MIZELL I (OWNER)
(478) 374-3116
Entity
Organization
Contact information
Practice address
634 MAIN ST, EASTMAN, GA 31023-6842
(478) 374-3116
Mailing address
634 MAIN ST, EASTMAN, GA 31023-6842
(478) 374-3116
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
36115
GA
Other
Enumeration date
06/22/2008
Last updated
06/22/2008
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