Organization
LIBERTY LAKE MEDICAL SUPPLY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW JAMES BRUMWELL (MANAGER/OWNER)
(509) 710-5259
Entity
Organization
Contact information
Practice address
22910 E APPLEWAY AVE STE 3, LIBERTY LAKE, WA 99019-8606
(509) 891-2856
(509) 891-0125
Mailing address
22910 E APPLEWAY AVE STE 3, LIBERTY LAKE, WA 99019-8606
(509) 891-2856
(509) 891-0125
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
01/02/2014
Last updated
01/02/2014
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