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Home Modifications >> Contractor >> Other Service Providers

Registrant NPI Number: 1922432525

Individual Registrant:
Gender: M
Not Sole Proprietor

Location and contact information for practice:
5011 NE COUNTY ROAD 1469  HAWTHORNE, FL 32640-9289 US
Tel: 352-475-1566  Fax: 352-475-5984

Contact information for business:
5011 NE COUNTY ROAD 1469  HAWTHORNE, FL 32640-9289 US
Tel: 352-475-1566  Fax: 352-475-5984

Registration Information:
NPI: 1922432525
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171WH0202XOther Service Providers
Home Modifications

Legacy codes, insurance codes and state license numbers:



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