| NPI | 1053850909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER WOLKEN Owner 314-727-6676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: MO 2008014689) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-02-13 |