| NPI | 1134249410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY ALAN HATHY Owner 904-292-3975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: FL FL3574) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2011-02-22 |