| NPI | 1649260852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAKE NICHOLSON Owner 337-560-5386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: LA 2942191001) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2008-06-12 |