Organization
THE DIABETIC STORE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALTONIA WILLIAMS (OWNER)
(214) 729-3410
Entity
Organization
Contact information
Practice address
2815 RED FOX CT, ARLINGTON, TX 76006-2659
(214) 729-3410
Mailing address
2815 RED FOX CT, ARLINGTON, TX 76006-2659
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
06/14/2016
Last updated
06/14/2016
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