| NPI | 1073399143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY WAINNER Credentialing 405-310-6881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2023-09-05 |
| Last Update Date | 2023-09-05 |