| NPI | 1164701330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAUHEEDAH M ROSS Techinician 770-922-9006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: GA BL-008270) |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2011-08-05 |