| NPI | 1710060207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WYNN SANDERS Owner 6622-378-4138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 485801SG) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2020-08-22 |