| Organization Name: | MODIFICATION CONCEPTS LLC |
| NPI Number: | 1366876567 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLES CLUTE (CEO) |
| Mailing Address: | 3105 Forest Shores Ln Highland Village |
| State: | TX US |
| Postal Code: | 750776487 |
| Phone Number: | 8007152563 |
| Fax Number: | 8885645237 |
| NPI Enumeration Date: | 08/25/2013 |
| NPI Last Update Date: | 08/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |