Organization
LIQUID BLUE OXYGEN, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE D FYOCK II (PRESIDENT)
(814) 385-1321
Entity
Organization
Contact information
Practice address
482 DONALDSON RD, KENNERDELL, PA 16374-1504
(814) 385-1321
(814) 385-1319
Mailing address
482 DONALDSON RD, KENNERDELL, PA 16374-1504
(814) 385-1321
(814) 385-1319
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
8000001243
PA
Other
Enumeration date
11/01/2006
Last updated
08/22/2020
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