| NPI | 1376054684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELL MONIQUE RIDDLE Owner 719-313-9649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2019-10-23 |