| NPI | 1487860532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY TIPTON KWAKUMEY Owner 678-985-1989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: GA 20019192637) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-08-22 |