Individual
MR. THOMAS LAVERNE HUSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
101022
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101022
DEPARTMENT OF HEALTH SERV
CA
01
—
14105
BUSINESS LICENSE CERT
CA
01
—
SR KHB 99288461
SELLERS PERMIT
CA
Enumeration date
04/14/2007
Last updated
09/06/2007
Update your record
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