| NPI | 1093394389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANZIA TIMMONS WALLACE Owner 843-624-0373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2021-09-03 |