Provider Demographics
NPI:1760899611
Name:MOBILITY ENHANCEMENT, LLC
Entity Type:Organization
Organization Name:MOBILITY ENHANCEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT TO MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:GRIFFITH
Authorized Official - Last Name:WADDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-993-0492
Mailing Address - Street 1:976 NORTH MARSHALL WAY, UNIT 1
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041
Mailing Address - Country:US
Mailing Address - Phone:801-719-6484
Mailing Address - Fax:801-719-6318
Practice Address - Street 1:976 NORTH MARSHALL WAY, UNIT 1
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041
Practice Address - Country:US
Practice Address - Phone:801-719-6484
Practice Address - Fax:801-719-6318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-11
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13828972-004-STC332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies