| NPI | 1770913626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHONBURI LEE Owner 651-373-0914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2013-11-13 |
| Last Update Date | 2013-11-13 |