Organization
RICKY LEE COLEMAN
Active
Other names
Jasper County Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
ALESHA GUNTER (OFFICE MANAGER)
(409) 622-2884
Entity
Organization
Contact information
Practice address
3148 COUNTY ROAD 480, KIRBYVILLE, TX 75956-4328
(409) 622-2635
Mailing address
PO BOX 1092, KIRBYVILLE, TX 75956-1092
(409) 622-2635
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/08/2012
Last updated
02/08/2012
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