| NPI | 1447242292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLY I VANSICKLE Owner 989-893-9480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2008-08-12 |