| NPI | 1780969717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCI DAVIS Owner 765-457-1553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IN 17001105A) |
| Enumeration Date | 2011-10-21 |
| Last Update Date | 2011-10-21 |