| NPI | 1659577104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA M WALL Owner 843-374-2299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 021168816) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2008-06-20 |