| NPI | 1427055201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS WAYNE MULLIN Owner/President 765-447-6323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: IN C15097) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2010-05-24 |