| NPI | 1164168027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA PRIDGEN Owner 704-456-5048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2022-05-12 |