NPI | 1124356993 |
---|---|
Entity Type | Organization |
Authorized Contact | MONTREAL C. GLOSSON Owner 920-257-6806 |
Organization Subpart ? | No |
Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
Enumeration Date | 2009-12-05 |
Last Update Date | 2009-12-05 |