| NPI | 1700483971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT KIRK Director Of Credentialing 708-710-9931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2020-10-01 |