| NPI | 1134878416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLIN NICKERSON President 224-730-4210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2022-03-22 |
| Last Update Date | 2022-09-14 |