| NPI | 1194533075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON LYNCH Owner 678-612-1457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-12-23 |
| Last Update Date | 2024-12-23 |