Organization
PORTABLE SLEEP SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA COATES CRT, RPSGT (MANAGER)
(309) 645-0689
Entity
Organization
Contact information
Practice address
820 SW ADAMS ST, PEORIA, IL 61602-1623
(309) 822-1046
Mailing address
480 TAZEWOOD RD, METAMORA, IL 61548-7302
(309) 822-1046
(309) 210-5247
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/22/2019
Last updated
06/22/2019
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