| NPI | 1104447697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER B. MAILLOUX Owner 570-650-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2020-05-06 |