| NPI | 1376624064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR S. SODERSTROM Owner 920-262-8822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2009-11-25 |