Basic Information
| Provider Information | |||||||||
| NPI: | 1033645031 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEXT LEVEL ASSISTIVE TECHNOLOGY INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 64568 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850824568 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4803747200 | ||||||||
| FaxNumber: | 4804219899 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 NE TENNEY RD | ||||||||
| Address2: | STE 110-330 | ||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986852831 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603268031 | ||||||||
| FaxNumber: | 3606398792 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2017 | ||||||||
| LastUpdateDate: | 05/11/2017 | ||||||||
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| AuthorizedOfficialLastName: | HOOKS | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | GOVERNOR | ||||||||
| AuthorizedOfficialTelephone: | 3603268031 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MS ED | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332BC3200X | Y | Suppliers | Durable Medical Equipment & Medical Supplies | Customized Equipment |
No ID Information.