| NPI | 1376508309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTA J JAYNES Owner Sole Propietor 618-467-0640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL A1735) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2015-06-18 |