| NPI | 1013609866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN T FULLER Manager 469-492-8155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2023-05-22 |
| Last Update Date | 2023-05-22 |