| NPI | 1134829690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKITTA SHUNTEL BLACK Owner 901-461-2756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2023-03-03 |
| Last Update Date | 2023-03-03 |