| NPI | 1376025288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER GRETCHEN WILCOX Owner 951-595-3433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA KK361269) |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2020-05-01 |