Organization
STARGATE MOBILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERIE A DODGE (OWNER)
(814) 598-2953
Entity
Organization
Contact information
Practice address
5688 ROUTE 219, BROCKPORT, PA 15823-1818
(814) 265-0838
(814) 265-2167
Mailing address
5688 ROUTE 219, BROCKPORT, PA 15823-1818
(814) 265-0838
(814) 265-2167
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/18/2006
Last updated
08/22/2020
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