Organization
OTP MEDICAL SUPPLIES, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNISSA DAVIS (OWNER)
(770) 990-0928
Entity
Organization
Contact information
Practice address
7162 LONE OAK WAY, LITHONIA, GA 30058-8291
(770) 990-0928
Mailing address
7162 LONE OAK WAY, LITHONIA, GA 30058-8291
(770) 990-0928
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/18/2021
Last updated
05/18/2021
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