Organization
PEPPERTOWN USA, LLC
Active
Other names
Theraquatics
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ELECTRA HENRY (CEO)
(334) 669-8838
Entity
Organization
Contact information
Practice address
704 N PERRY ST, MONTGOMERY, AL 36104-2442
(334) 669-8838
Mailing address
PO BOX 1414, MONTGOMERY, AL 36102-1414
(334) 669-8838
Taxonomy
Speciality
Code
Description
License number
State
332BN1400X
Nursing Facility Supplies (DME)
Primary
R006584441
AL
Other
Enumeration date
08/24/2015
Last updated
08/24/2015
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