| NPI | 1124663091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN HAGGLER President 336-757-0495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2019-11-14 |