| NPI | 1770837296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH DANIEL RADLICK Owner 855-789-2284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MI 2101170519) |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2012-11-06 |