| NPI | 1740651488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNIE JEAN ENGLE Owner 765-465-4563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: IN 17001318A) |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2015-10-07 |