| NPI | 1730631078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLE WALACE Owner 770-820-9566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2016-11-03 |
| Last Update Date | 2016-11-03 |