| NPI | 1639691355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL L SCHROCK Owner 308-440-7796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2023-05-08 |