| NPI | 1225380454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVENELL LETIONER ASH Owner 218-343-0165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2012-10-11 |
| Last Update Date | 2012-10-11 |