| NPI | 1174877849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE JESSEE Manager 270-651-5159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY p07492) |
| Enumeration Date | 2012-11-02 |
| Last Update Date | 2014-04-21 |