| NPI | 1457765372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY MAC RUST Owner/Manager 817-454-6365 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2014-07-02 |