| NPI | 1144993221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAVON JOHNSON Owner 843-758-0085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2021-07-26 |
| Last Update Date | 2021-07-26 |