Organization
GREAT LAKES MEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVAN KYLE PRUETER (PRESIDENT)
(419) 872-5343
Entity
Organization
Contact information
Practice address
25660 DIXIE HWY, PERRYSBURG, OH 43551-2167
(419) 872-5343
(419) 872-7464
Mailing address
25660 DIXIE HWY, PERRYSBURG, OH 43551-2167
(419) 872-5343
(419) 872-7464
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/05/2009
Last updated
03/05/2009
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