| NPI | 1568848539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAINE MULL Owner 989-439-1183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2021-12-21 |