| NPI | 1144788290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY J GRYGER Office Manager 518-563-7620 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2024-04-09 |