| NPI | 1770635609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN TEEVAN President 262-786-9870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WI 220146) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-08-22 |