| NPI | 1013384627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA AE BOUAPAENGPHAN Owner 507-722-7587 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2015-08-31 |