| NPI | 1134288996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN KOLAKOWSKI President 731-668-8802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TN 4609761) |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2019-05-23 |