| NPI | 1053936484 |
|---|---|
| Doing Business As | KOALA CENTER FOR SLEEP & TMJ DISORDERS - IN3 |
| Entity Type | Organization |
| Authorized Contact | RODNEY WILLEY Owner 309-303-0426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2020-09-10 |