| NPI | 1104481233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN CONRAD KONING Owner 469-252-4777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2019-05-03 |