| NPI | 1255781860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT NICHOLS Owner 866-984-0165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2019-12-12 |