| NPI | 1417573916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VAISHALI LALE President 618-659-5572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2023-05-23 |