MARY DIANE JOHNSON TMD OUTLET

LEBANON, MO
NPI1649389388
Entity TypeOrganization
Authorized ContactMARY D JOHNSON
Owner/Abc Certified Fitter (Rem0094
417-588-3404
Organization Subpart ?No
Primary Taxonomy225000000X Orthotic Fitter
Enumeration Date2006-08-29
Last Update Date2008-06-16
Business Address
MARY DIANE JOHNSON TMD OUTLET
702 S MONROE
LEBANON, MO 65536-3570
Phone number: 417-588-3404
Mailing Address
MARY DIANE JOHNSON TMD OUTLET
702 S MONROE
LEBANON, MO 65536-3570
Phone number: 417-588-3404