B Laced Medical Supply LLC
NPI #1770433898 in Manteca, California
Provider Information
- NPI Number
- 1770433898
- Entity Type
- Organization
- Organization Name
- B Laced Medical Supply LLC
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- Jan 29, 2026
- Last Updated
- Jan 29, 2026
Practice Location
- Address
- 1528 SHIRLEY AVE
- City
- Manteca
- State
- California
- ZIP Code
- 95337
- Phone
- (209) 972-0340
Authorized Official
- Name
- DEOZENE STONE
- Title
- MANAGING MEMBER
- Phone
- (209) 972-0340
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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