| NPI | 1336261205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA FOWLER Manager 229-432-7012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: GA 021643) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2013-06-19 |