| NPI | 1609245471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORA ANN POE Owner/Manager 662-418-4316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2015-09-22 |