| NPI | 1194178137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL JOE WILSON Director 503-209-0335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-07-14 |