| NPI | 1265597645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE BANIA Administrator 414-744-6589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2017-04-06 |