| NPI | 1699776088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KPOTO OKON ISANGEDIGHI Owner 336-389-9343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NC 600442227) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2010-03-04 |