| NPI | 1770893927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT B BOHOLST President 813-973-8555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: FL 13536) |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2010-10-20 |