| NPI | 1518983881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WYATT WALTMAN Owner 601-936-4943 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 061184354) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2020-08-22 |