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Individual

MR. LENNY J JOSEPH JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1741 OAK HILL RD, SUITE A, EVANSVILLE, IN 47711-4371
(812) 454-5588
(888) 424-4394
Mailing address
PO BOX 4183, EVANSVILLE, IN 47724-0183
(812) 454-5588
(888) 424-4394

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200810190A
MEDICAID WAIVER
IN
05
200811860A
IN
Enumeration date
01/02/2007
Last updated
08/21/2013
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