| NPI | 1538141643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE THOMPSON Co Owner 618-452-4013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 203000578) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2020-08-22 |