| NPI | 1043579881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE ELLEN WILSON Owner 469-323-5474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2012-05-14 |