| NPI | 1386875714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK STEVEN KELLY Owner 910-458-7799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NC 01533) |
| Additional Taxonomies | 251K00000X Public Health or Welfare (Licence: NC 3418849) |
| Enumeration Date | 2009-08-03 |
| Last Update Date | 2010-11-04 |