| NPI | 1679609754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS ANTHONY RACZ Partner 843-735-2207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2008-07-25 |