| NPI | 1447536057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSIE RAYLENE PRUITT Owner 806-322-0941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 1000557) |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2011-10-26 |