| NPI | 1154422160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALDINE JACKSON President 770-947-3967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2022-07-21 |