| NPI | 1205416419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSIE MATHIS Owner 920-257-4902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2021-04-12 |