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Organization

WP SUPPLY EAST

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHRISTOPHER OTIKO DPM (PRESIDENT)
(818) 836-2475
Entity
Organization

Contact information

Practice address
3117 NORBROOK DR, MEMPHIS, TN 38116-1614
(323) 289-2535
Mailing address
4640 ADMIRALTY WAY STE 500, MARINA DEL REY, CA 90292-6636
(323) 480-4075

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
332BN1400X
Nursing Facility Supplies (DME)

Other

Enumeration date
06/25/2022
Last updated
06/25/2022
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