NPI | 1235700014 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES L DERRICO Owner 630-399-7367 |
Organization Subpart ? | No |
Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2021-07-02 |
Last Update Date | 2023-08-03 |