| NPI | 1164432126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | E REISZ Owner 270-683-7379 |
| Organization Subpart ? | |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition (Licence: KY P02023) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-08-22 |