| NPI | 1235313859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT BRADSHAW Owner/President 219-227-6612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IN 0127207732) |
| Enumeration Date | 2007-12-18 |
| Last Update Date | 2008-06-11 |