| NPI | 1154712370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS GLEN WINGER Member 885-581-7082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TN 0000001248) |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2018-09-21 |