| NPI | 1134398852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN FRANCIS NICHOLSON Owner 651-489-4194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2010-02-25 |