| NPI | 1639155021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVA WYNELL PEREZ Sole Proprietor 229-671-1161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2020-08-22 |