| NPI | 1538423413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OVOILETTE E HOLT Manager 904-269-3488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: FL DN-14358) |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2012-06-26 |