Organization
LTC PROVIDERS, INC.
Active
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
Enumeration date
03/30/2007
Last updated
08/22/2020
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