| NPI | 1245561661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT JOY VAN DIGGELEN Member 815-444-7239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2010-01-25 |
| Last Update Date | 2010-01-25 |