| NPI | 1639239171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY GIZE Md Owner 260-484-8830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IN 60005894) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2019-08-01 |