| NPI | 1215262738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY A TEBBS President 253-225-6770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2010-10-14 |