| NPI | 1487498572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAWANA MARSHALL Director 318-458-7886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2024-06-24 |
| Last Update Date | 2024-06-24 |