| NPI | 1710994348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PENNIE JO WATKINS Vice President 352351-873-4411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 1264) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2020-08-22 |