| NPI | 1407914153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW MOUTON Owner 708-364-0261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: IL 203000642) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2014-04-29 |