| NPI | 1780019422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TISHAWANA CRAFT Manager 347-728-2568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2013-09-12 |