| NPI | 1487278917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA FROMKIN Credentialing Mgr 706-570-0220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2023-08-18 |