| NPI | 1215299227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA GIBSON Manager 806-771-5873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TX P108364M) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2012-06-14 |