| NPI | 1659740058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY LYNN VANDENBERG Sole Owner 269-329-3287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2015-09-16 |