| NPI | 1063189579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEWART L GIBSON Member 404-255-4553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2021-08-24 |