| NPI | 1114964483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASEY NICHOLAS TEBBS Owner 253-377-1358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2021-07-13 |