| NPI | 1578915120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH AARON LEWIS Owner 217-994-9417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2017-02-27 |