| NPI | 1659991677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAKE JENTRY ANDERSON Organizing Member 517-348-0845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2020-04-20 |