| NPI | 1518020478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNIE ALLEN VP 772-429-1730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: FL 1538) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2011-06-22 |