| NPI | 1376563981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY TEAGUE Owner 877-785-1357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 16) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2022-07-21 |