| NPI | 1235375635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANYELLE CARROLL CEO 662-324-1411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: MS 07916) |
| Enumeration Date | 2009-01-06 |
| Last Update Date | 2009-01-06 |