| NPI | 1417085903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VAN DB CLARK JR Owner 515-282-8808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-08-22 |