| NPI | 1508241993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IAN M RAE Owner 937-879-1321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2015-07-27 |