| NPI | 1023180411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAVONNE MAE NIEMCZYK Owner 405-348-7923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OK 189873) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2020-08-22 |