Organization
LEATHER BANANA,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL LEIPPERT (OWNER)
(574) 254-0517
Entity
Organization
Contact information
Practice address
602 N MAIN ST, MISHAWAKA, IN 46545-6620
(574) 254-0517
(574) 254-0162
Mailing address
602 N MAIN ST, MISHAWAKA, IN 46545-6620
(574) 254-0517
(574) 254-0162
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
5651070001
IN
Other
Enumeration date
05/28/2006
Last updated
10/11/2012
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