| NPI | 1629519020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HASEEB KHAN Administrator 651-217-8173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-03-17 |
| Last Update Date | 2017-04-12 |