Organization
INDEPENDENT MOBILITY PLUS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVAN PARKER (OWNER / PRESIDENT)
(920) 965-6000
Entity
Organization
Contact information
Practice address
450 N MILITARY AVE, SUITE #7, GREEN BAY, WI 54303-4570
(920) 965-6000
(920) 491-0527
Mailing address
450 N MILITARY AVE, SUITE #7, GREEN BAY, WI 54303-4570
(920) 965-6000
(920) 491-0527
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41750600
—
WI
Enumeration date
05/20/2006
Last updated
08/22/2020
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