| NPI | 1467327759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL MICHELLE JOHNSON Owner 580-280-2558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2025-10-07 |
| Last Update Date | 2025-10-20 |