| NPI | 1275767584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL TYSON POE President 317-605-9327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IN 69000592A) |
| Enumeration Date | 2009-05-14 |
| Last Update Date | 2011-08-26 |