| NPI | 1740643709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY GLENN MOORE Owner 662-816-6866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2016-03-29 |