| NPI | 1457243503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHERY LEE HYSONG Owner 347-992-1576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2025-07-15 |
| Last Update Date | 2025-07-15 |