| NPI | 1134913064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN J BEAR Authorized Official 815-398-9491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2025-04-07 |
| Last Update Date | 2025-04-07 |