NPI | 1114342847 |
---|---|
Doing Business As | KOALA CENTER FOR SLEEP DISORDERS |
Entity Type | Organization |
Authorized Contact | RODNEY EARL WILLEY Owner 309-376-8385 |
Organization Subpart ? | No |
Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
Additional Taxonomies | 122300000X Dentist (Licence: WI 3272) |
Enumeration Date | 2014-03-05 |
Last Update Date | 2020-09-10 |