| NPI | 1669776126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY HAROLD QUELLET President 706-233-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: GA 20115654383) |
| Enumeration Date | 2010-12-27 |
| Last Update Date | 2011-07-20 |