| NPI | 1023389152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM RUSSELL YEARWOOD Owner 601-606-0711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2012-01-20 |
| Last Update Date | 2021-02-04 |