| NPI | 1588932446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARRY M MARTIN Owner 715-384-3323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WI 52325) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: WI 52325) |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: WI 52325) | |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2011-12-07 |