| NPI | 1669850137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN HANSON Owner 414-810-1299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2015-07-22 |