NPI | 1194799635 |
---|---|
Entity Type | Organization |
Authorized Contact | JEFFREY MATUKEWICZ Secretary 423-756-2268 |
Organization Subpart ? | No |
Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA 100961) |
Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
Enumeration Date | 2006-02-13 |
Last Update Date | 2022-08-08 |