Organization
LIFE ESSENTIALS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHY SMITH (OWNER)
(765) 563-3158
Entity
Organization
Contact information
Practice address
8796 S US HIGHWAY 231, BROOKSTON, IN 47923-8018
(765) 563-3158
(765) 563-3257
Mailing address
8796 S US HIGHWAY 231, BROOKSTON, IN 47923-8018
(765) 563-3158
(765) 563-3257
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
12/08/2010
Last updated
12/08/2010
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