| NPI | 1487914644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERSCHEL PEDDICORD President/CEO 262-373-0422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2012-05-22 |