| NPI | 1396800629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK WELLS Owner 270-926-8999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OH 332B00000X) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-22 |