| NPI | 1437356508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE ALAN RUNGE Manager 262-781-7690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies |
| Enumeration Date | 2007-07-01 |
| Last Update Date | 2007-12-18 |