| NPI | 1770659468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODY COULTER Com PT Roller 915-544-1906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NM 4093) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2016-11-28 |