Organization
LTC PROVIDERS, INC
Active
Other names
LTC PROVIDERS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY D LOCK (PRESIDENT OWNER)
(573) 860-6800
Entity
Organization
Contact information
Practice address
115 PROGRESS PKWY, SULLIVAN, MO 63080-2359
(573) 860-6800
(573) 860-6801
Mailing address
PO BOX 69, SULLIVAN, MO 63080-0069
(573) 860-6800
(573) 860-6801
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
15522814
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
627718802
—
MO
Enumeration date
06/09/2006
Last updated
05/27/2011
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