| NPI | 1639293988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER TARDIF Credentialing Manager 770-801-2526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: GA 035504) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2009-01-08 |