| NPI | 1033315148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE JENKINS Provider Enrollment COO Rdinator 417-829-4264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2010-06-02 |