Individual
MR. JOHN R PIERCE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ORTHOTIST PROSTHETIS
Contact information
Practice address
107 W WAY ST, SUITE 13, LAKE JACKSON, TX 77566-5219
(979) 299-0005
(979) 299-0008
Mailing address
PO BOX 2286, LEAGUE CITY, TX 77574-2286
(979) 299-0005
(979) 299-0008
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010721101
—
TN
Enumeration date
02/06/2007
Last updated
11/10/2010
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