Individual
MR. KOFO A ADEREMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4617 S. BUCKNER BLVD., SUITE J, DALLAS, TX 75227
(504) 251-5564
Mailing address
4617 S. BUCKNER BLVD., SUITE J, DALLAS, TX 75227
(504) 251-5564
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
59-4772
LA
Other
Enumeration date
12/31/2008
Last updated
12/31/2008
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