| NPI | 1609485697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAWANNA LAQUITHA MYLES Owner 346-243-0948 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-07-27 |
| Last Update Date | 2020-07-27 |