| NPI | 1194902890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON SCOT PERCIVAL Owner 803-285-1411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-01-24 |
| Last Update Date | 2008-01-24 |