| NPI | 1629111315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN P WILSON Owner 806-355-2924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 12662) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2020-08-22 |