| NPI | 1689868804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN SYDNEY WELLUM President 239-213-9458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 4035490001) |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2007-08-30 |