| NPI | 1518996487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY O RIDDLE Owner 870-448-5984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AR MG00478) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2007-11-08 |