| NPI | 1114398054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEENA KILLINGSWORTH Member 972-202-3497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2016-01-07 |