| NPI | 1730849951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY S SMITH Owner 904-383-5916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2021-12-29 |
| Last Update Date | 2021-12-29 |