Divine, Johnny Leo

Divine, Johnny Leo is an sole proprietor health care provider with primary practice located at 507 Main Street , Golden City MO 64748. He recently has only one registered license in Suppliers / Customized Equipment, which is considered as his primary health care specialty. Divine, Johnny Leo can be contacted via phone (417) 262-2524.

Contact Information

Primary practice address
507 Main Street Golden City MO 64748
Phone: (417) 262-2524
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Customized Equipment 332BC3200X

Profile Details

NPI number 1275092991
LBN Legal business name Divine, Johnny Leo
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 13th, 2019
Last updated Mar 13th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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