| NPI | 1790663466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK JON KINNEY Owner 218-750-9308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171WH0202X Contractor, Home Modifications |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2025-08-21 |
| Last Update Date | 2025-08-26 |