| NPI | 1366746695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN GORDON VAN KIRK Owner 904-829-2846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2010-12-30 |
| Last Update Date | 2010-12-30 |