| NPI | 1114302155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOWARD MCKOWN Member 765-452-9717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2015-07-20 |