Provider Demographics
NPI:1255840757
Name:WAV MOBILITY CONSULTANTS, LLC
Entity Type:Organization
Organization Name:WAV MOBILITY CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RADACOSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-206-5334
Mailing Address - Street 1:875 W SPUR AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-6235
Mailing Address - Country:US
Mailing Address - Phone:602-206-5334
Mailing Address - Fax:888-346-2025
Practice Address - Street 1:875 W SPUR AVE
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-6235
Practice Address - Country:US
Practice Address - Phone:602-206-5334
Practice Address - Fax:888-346-2025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment