Organization
COPPER CREEK MEDICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALFRED A TALL RRT, RPSGT (PRESIDENT)
(509) 998-4309
Entity
Organization
Contact information
Practice address
17700 SE 272ND ST, SUITE 350, COVINGTON, WA 98042-4951
(253) 372-7325
(253) 372-7321
Mailing address
1512 N VERCLER RD, SUITE 1, SPOKANE VALLEY, WA 99216-1087
(509) 465-5522
(509) 465-2642
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
05/10/2012
Last updated
05/10/2012
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