MR. Jerry Lee Stout, OST
NPI #1598878837 in River Forest, Illinois
Provider Information
- NPI Number
- 1598878837
- Entity Type
- Individual
- Name
- MR. Jerry Lee Stout, OST
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Durable Medical Equipment & Medical Supplies - Customized Equipment
- Credential
- OST
- Enumeration Date
- Aug 17, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 7379 W NORTH AVE
- City
- River Forest
- State
- Illinois
- ZIP Code
- 60305-1230
- Phone
- (708) 771-4528
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies - Customized Equipment — Customized Equipment |
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