| NPI | 1093368607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL L BLOHOWIAK President 920-324-9899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2022-05-05 |