| NPI | 1629015904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORY D SKWOR President 773-292-1940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2023-06-29 |