| NPI | 1710235254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUNA A MUCKLOW Owner 308-237-3044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NE 171W00000X) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2012-08-15 |