| NPI | 1023028420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANDALA NICOLE SMITH Owner 870-763-7993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2007-07-18 |