| NPI | 1770229445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI A RUSS Vice President Of Operations 815-730-3344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2022-05-06 |
| Last Update Date | 2022-05-06 |