| NPI | 1720686579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN BRYANT Part Owner 231-935-0957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-10-14 |
| Last Update Date | 2020-10-14 |