| NPI | 1174694293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSELYN A JACK Administrator 817-633-7787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-11-11 |
| Last Update Date | 2022-07-21 |