| NPI | 1326301292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN DEVINE Owner 6152-694-2909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: TN DS5009) |
| Enumeration Date | 2012-06-16 |
| Last Update Date | 2013-08-08 |