| NPI | 1215211636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID RUSSELL MOSS Owner 314-324-5554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2014-02-04 |