| NPI | 1649736505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH-LAISNE' WALDRON Bookkeeper 907-780-4872 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-02-15 |
| Last Update Date | 2019-02-15 |