Organization
WEST COAST DME & SUPPLIES LLC
Active
Other names
OrthoKinetix
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL GREGORY WELLS CPED (COO)
(909) 477-3117
Entity
Organization
Contact information
Practice address
30101 AGOURA CT STE 114, AGOURA HILLS, CA 91301-4301
(909) 477-3117
(909) 303-9244
Mailing address
1835 CHICAGO AVE STE A, RIVERSIDE, CA 92507-2309
(909) 477-3117
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
77673
CA
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
CA
Other
Enumeration date
12/12/2017
Last updated
12/12/2017
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