| NPI | 1104254796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE LEE STAUFFER President 817-835-0035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Additional Taxonomies | 171WH0202X Contractor Home Modifications |
| 171WV0202X Contractor Vehicle Modifications | |
| Enumeration Date | 2013-10-17 |
| Last Update Date | 2013-10-22 |