| NPI | 1407571565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OGHENEVWOGAGA OPHORI Owner 786-438-7806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2022-10-11 |
| Last Update Date | 2025-09-09 |