| NPI | 1417184177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD LEE VAN WAES President 731-343-9880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2009-06-19 |