| NPI | 1588155857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE MARQUARDT CEO 888-412-0370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: PA 6000009358) |
| Additional Taxonomies | 224900000X Mastectomy Fitter |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2023-04-13 |