| NPI | 1659031391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA D MOORE Owner 817-930-2595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2021-12-21 |
| Last Update Date | 2022-04-21 |