| NPI | 1073036745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON BOYANOSKI Owner 570-780-0443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2019-06-11 |