| NPI | 1215287057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS HUDNALL President 270-651-5159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: KY p07492) |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2012-09-19 |