| NPI | 1669895249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA DENICE JACKSON Owner 719-821-8222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2014-02-01 |
| Last Update Date | 2014-02-01 |