Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JOHNNY LEO DIVINE
Active Sole ProprietorJOHNNY LEO DIVINE is a Customized Equipment (DME) healthcare provider located in GOLDEN CITY, Missouri. NPI 1275092991 is currently active in the NPPES registry. Verify at CMS.
Customized Equipment (DME) · GOLDEN CITY, MO
Registration Details
- NPI Number
- 1275092991
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 13, 2019 (7.4323787024706 yrs)
- Last Updated
- Mar 13, 2019
- Sole Proprietor
- Yes
Practice Information
- Address
-
507 MAIN STREETGOLDEN CITY, MO, 64748Browse MO providers · Browse ZIP 64748
- Phone
- 4172622524
- Primary Specialty
-
Customized Equipment (DME)
332BC3200X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.