| NPI | 1043698582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY ELLIOTT Owner 740-441-1645 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: OH HMER23298-ACHC) |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2015-05-18 |