| NPI | 1598999567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALPHONSO DEWAYNE BRYANT Owner 478-476-0201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: GA 73) |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2009-05-13 |