| NPI | 1669886529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCELL CHUN General Manager 770-827-9801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: GA 2014013941) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2014-11-17 |