| NPI | 1699790568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELL JOSEPH PELLERIN Owner 318-215-9399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2008-04-20 |