| NPI | 1538419072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICKEY JENNINGS BROCIES President/Owner 815-744-5212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2012-09-12 |