| NPI | 1215267059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHAN TYLER BRAGG President 318-542-3694 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2009-12-29 |
| Last Update Date | 2010-05-11 |