| NPI | 1386139251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA MANDERNACH Manager 636-751-4188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2018-06-24 |
| Last Update Date | 2018-06-24 |