| NPI | 1326387432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEWAYNE M TENTLER President 815-516-7396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2013-02-08 |
| Last Update Date | 2013-02-08 |