NPI | 1790782480 |
---|---|
Entity Type | Organization |
Authorized Contact | DENISE EDMAN President/Owner 815-741-0712 |
Organization Subpart ? | No |
Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 203000549) |
Enumeration Date | 2005-07-07 |
Last Update Date | 2017-09-06 |