| NPI | 1144355199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULINE R MCCANLESS Owner 317-209-8004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: IN 69000088A) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2007-09-25 |