| NPI | 1700623345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLOVER SISAMOUTH Partner 515-554-1468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2024-07-11 |
| Last Update Date | 2025-03-11 |