| NPI | 1215121629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL KUNZE Owner 417-358-8566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MO 000634) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: MO 000634) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: MO 000634) | |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2008-09-30 |