| NPI | 1285972638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD KEITH BULLOCK Owner/Operator 866-914-7336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: NC 2571068) |
| Enumeration Date | 2013-01-18 |
| Last Update Date | 2013-01-18 |