| NPI | 1730839713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIESE WALLACE Owner 929-499-5020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2022-03-24 |