Organization
SPORTOPEDICS MEDICAL SHOPPE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD A. DUNLAP (OWNER/PRESIDENT)
(937) 475-7210
Entity
Organization
Contact information
Practice address
1222 S PATTERSON BLVD, SUITE #130, DAYTON, OH 45402-2684
(937) 461-2663
(937) 461-3448
Mailing address
1222 S PATTERSON BLVD, SUITE #130, DAYTON, OH 45402-2684
(937) 461-2663
(937) 461-3448
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0301408
—
OH
Enumeration date
01/03/2006
Last updated
06/28/2012
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