Individual
ELIZABETH IBITORU OKETOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DME PROVIDER
Contact information
Practice address
16756 FOOTHILL BLVD, FONTANA, CA 92335
(909) 350-9700
(909) 350-7340
Mailing address
PO BOX 766, RANCHO CUCAMONGA, CA 91729
(909) 350-9700
(909) 350-7340
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/15/2006
Last updated
07/08/2007
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