| NPI | 1013913169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN JOSEPH BAN Owner 239-590-0167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 1312191) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2011-05-09 |