| NPI | 1568577641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE LEON ELLIS President 764-555-1810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: IN 0002243580) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2008-03-14 |