| NPI | 1164059150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON TEVZ Owner 414-758-2900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171WV0202X Contractor, Vehicle Modifications |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2020-03-27 |