| NPI | 1518145887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON MANUEL Owner 904-223-8818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 6580198195) |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2010-08-18 |