| NPI | 1689914079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN KOLAKOWSKI President 731-668-8802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2019-06-18 |