| NPI | 1528423761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA DENNIS Office Manager 765-452-4677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IN 12009803) |
| Enumeration Date | 2015-12-15 |
| Last Update Date | 2015-12-15 |