| NPI | 1205006079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KURTIS M CARLSON Owner 217-222-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 046-008272) |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2013-09-26 |