| NPI | 1205107208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA ELLISON Owner 866-289-8072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 023091440) |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2013-09-03 |