| NPI | 1609059971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALLACE LAYNE SISLER Partner 719-201-6231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2007-12-10 |