| NPI | 1205653607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES ALBERT CLARK Owner 984-304-5676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2024-09-25 |
| Last Update Date | 2026-03-19 |