| NPI | 1013555838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA FROMKIN Credentialing Director 706-494-3071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-12-11 |
| Last Update Date | 2020-02-12 |