| NPI | 1710201504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRIE MARIE MCCORMACK Owner 386-755-9522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL RN3192592) |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2010-03-23 |