| NPI | 1437711702 |
|---|---|
| Doing Business As | MIRACLY STORE |
| Entity Type | Organization |
| Authorized Contact | LA LY Owner 559-981-2787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2019-07-08 |