| NPI | 1093130122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER A JEFFREY Manager 708-497-0831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2014-02-26 |