| NPI | 1760732655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE WILFORD Owner 317-721-9753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2012-09-18 |