| NPI | 1578253282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS ODIN HANSEN Owner 832-668-5546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 213E00000X Podiatrist |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2023-05-22 |