| NPI | 1013676840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL ROTH Owner 260-748-3650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2021-12-09 |
| Last Update Date | 2022-11-16 |