| NPI | 1730541830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD LEWIS WALDOCH President 651-464-3215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2016-03-28 |