| NPI | 1154562619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA FAGERSTROM Office Manager 716-483-3696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2009-03-13 |
| Last Update Date | 2009-03-13 |