| NPI | 1235357260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA L MATTSON Senior Credentialing Coordinator 214-473-7043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2008-07-02 |