| NPI | 1124025465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TY JONES Manager 731-660-6116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TN 748) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2023-01-25 |