| NPI | 1194231225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY PETROCELLI Rpsgt/Owner 936-701-0899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-12-27 |
| Last Update Date | 2017-12-27 |