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Individual

MR. SAMSTEVE B OMBAT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
855 E MISHAWAKA RD LOT 13, ELKHART, IN 46517-2394
(574) 322-8520
Mailing address
855 E MISHAWAKA RD LOT 13, ELKHART, IN 46517-2394
(574) 322-8520

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
332BC3200X
Customized Equipment (DME)

Other

Enumeration date
10/11/2011
Last updated
10/11/2011
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