| NPI | 1104284306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN BANKS Secretary 770-575-5361 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2016-02-02 |