| NPI | 1083662704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY SHOOPMAN Office Manager 270-433-5806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: KY 195) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2009-12-02 |