Johnny Leo Divine
Johnny Leo Divine is a Customized Equipment (DME) in Golden City, Missouri. Practices as a sole proprietor. Registered with an NPI since 2019.
- In the registry since
- 2019
Practice location Address checks out
507 Main StGolden City, MO 64748
Phone: (417) 262-2524
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Customized Equipment (DME) (primary) | Taxonomy 332BC3200X |
|---|
Record details
| NPI number | 1275092991 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | March 13, 2019 |
| Last updated in NPPES | March 13, 2019 |
| Mailing address | Po Box 41, Golden City, MO 64748 |