Organization
AT MEDICAL EQUIPMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KELLY LYERLA (OWNER)
(618) 570-8345
Entity
Organization
Contact information
Practice address
6651 GLADEL DR, WATERLOO, IL 62298-5055
(618) 570-8345
(618) 473-2035
Mailing address
6651 GLADEL DR, WATERLOO, IL 62298-5055
(618) 570-8345
(618) 473-2035
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
09/13/2013
Last updated
09/13/2013
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