| NPI | 1316448111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONNIE WIGFALL Owner 803-257-8131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 111266264) |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2018-02-27 |