| NPI | 1700051711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND STIDD Provider 812-330-0909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: IN 280-B) |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2009-11-23 |