| NPI | 1104957471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN H CLARK Ins Rep 803-806-8198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 8938) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |