Organization
INCOBA LLC
Active
Other names
Dynaris
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALONZO C AYLSWORTH (CEO/CTO)
(314) 920-2777
Entity
Organization
Contact information
Practice address
743 SPIRIT 40 PARK DR STE 108, CHESTERFIELD, MO 63005-1121
(636) 778-1926
Mailing address
743 SPIRIT 40 PARK DR STE 108, CHESTERFIELD, MO 63005-1121
(636) 778-1926
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
04/08/2025
Last updated
04/08/2025
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