| NPI | 1497007595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALLAS POWERS Managing Partner 616-835-3304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: IL 212.000175) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: IL 212.000175) |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: IL 212.000175) | |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: IL 212.000175) | |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2012-10-12 |