| NPI | 1114152428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANCE GEORGE Owner 251-478-1805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AL 903) |
| Enumeration Date | 2009-05-17 |
| Last Update Date | 2009-05-17 |