Organization
JS&H ORTHOPEDIC SUPPLY L L C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SYLVIA JEAN WILLETT (OWNER)
(817) 624-0102
Entity
Organization
Contact information
Practice address
4410 W VICKERY BLVD, SUITE 104, FORT WORTH, TX 76107-6242
(817) 624-0102
(817) 624-9950
Mailing address
4410 W VICKERY BLVD, SUITE 104, FORT WORTH, TX 76107-6242
(817) 624-0102
(817) 624-9950
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0067955A
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172326401
—
SC
01
—
531352
BCBS
—
Enumeration date
07/07/2005
Last updated
06/20/2008
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