| NPI | 1659540474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS DALE PURVIS Administrator/Owner 225-295-8183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2009-11-03 |