| NPI | 1770712531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY A KISLA Owner 815-485-2727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 042618144) |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2010-08-27 |