| NPI | 1295456465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ROBERT VANCE Member 225-925-2096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2022-09-07 |
| Last Update Date | 2024-02-26 |