| NPI | 1730611039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY MONIQUE WATERS Co Owner 225-775-9406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: LA 1014) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2017-03-28 |