| NPI | 1356772396 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | LETICIA POWERS Member 260-515-3609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2013-12-02 |