| NPI | 1518471952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON OVERLAND Owner 210-951-8263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2019-03-26 |