| NPI | 1164055976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JO TURLEY Medical Staff Coordinator 217-545-7876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-02-20 |
| Last Update Date | 2020-05-11 |