| NPI | 1093713463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS KYLE HUDNALL Owner/President 270-651-8359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: KY P07216) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2009-01-27 |