| NPI | 1184412082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON COREY GOODMAN Owner 314-629-5794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2025-04-29 |
| Last Update Date | 2025-04-29 |