| NPI | 1750863866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISE FULLWOOD President 769-300-2418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2018-09-05 |