| NPI | 1043849219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARRETT LONG Managing Member 336-757-2570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2021-10-25 |