| NPI | 1114584992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVIN L HOLLOMAN Owner 219-229-6220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2020-06-03 |