| NPI | 1720047640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS C WALT President 904-241-5310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL Not required) |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2011-04-25 |