| NPI | 1649400573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL MACEY Executive Director 385-887-6275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2022-04-27 |