| NPI | 1134608292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FALANDA LEE SHELTON Owner 678-531-5604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2018-08-09 |