| NPI | 1407656572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS SIDNEY BLACKSTAD President 918-605-6582 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2025-03-17 |
| Last Update Date | 2025-03-17 |