Organization
MDW INNOVATIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICAH DEAN WHITLOW (CEO/FOUNDER)
(928) 613-2240
Entity
Organization
Contact information
Practice address
1960 S ARIZONA AVE, APT B, YUMA, AZ 85364-5784
(928) 613-2240
Mailing address
PO BOX 1775, YUMA, AZ 85366-2381
(928) 613-2240
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
01/14/2013
Last updated
01/14/2013
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