| NPI | 1538351549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE BANIA Administrator 414-744-6589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2022-07-21 |