| NPI | 1043838014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA WOOD Authorized Official 270-872-4405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2020-07-07 |