| NPI | 1023408424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY WABLONG LEE CEO 262-352-6217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2015-01-23 |
| Last Update Date | 2015-01-23 |