| NPI | 1174211627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAIRYS GALVEZ GRANADOS Member 336-609-9024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2023-04-24 |
| Last Update Date | 2023-04-24 |