| NPI | 1669692190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA FUNDENBERGER Owner 317-547-5525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IN 01036129A) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Licence: IN 01036129A) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2013-06-21 |