| NPI | 1659902062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASEY CUBBEDGE Owner 225-256-6456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2024-02-19 |