Organization
ACTIVE MOBILITY SUPPLY, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON MATTHEW WALDEN (MANAGING MEMBER)
(501) 835-0100
Entity
Organization
Contact information
Practice address
6100 GETTY DRIVE, SUITE E, NORTH LITTLE ROCK, AR 72117
(501) 835-0100
(501) 835-0103
Mailing address
6100 GETTY DRIVE, SUITE E, NORTH LITTLE ROCK, AR 72117
(501) 835-0100
(501) 835-0103
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
09/19/2006
Last updated
11/10/2008
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