| NPI | 1659632370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILL FOSSUM Regional Manager 586-991-5964 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2012-06-18 |