| NPI | 1265571616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOBBY ROYCE LOGAN Manager 806-780-2642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 0034595) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2008-03-28 |