| NPI | 1407396500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON KEITH RIDGEL Owner 805-587-6569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-03-08 |
| Last Update Date | 2017-03-08 |