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Organization

JEB MEDICAL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BRIAN A KING (PRINCIPAL)
(816) 695-4929
Entity
Organization

Contact information

Practice address
1215 CLAY ST, KANSAS CITY, MO 64116-4026
(816) 695-4929
Mailing address
1215 CLAY ST, KANSAS CITY, MO 64116-4026
(816) 695-4929

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
LC1242724
MO
363AS0400X
Surgical Physician Assistant
364SM0705X
Medical-Surgical Clinical Nurse Specialist

Other

Enumeration date
07/24/2012
Last updated
09/14/2012
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