| NPI | 1114485042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN PAYNE COO 469-485-2382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2022-08-22 |