| NPI | 1801459227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA STACY Senior Accountant 678-387-6631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2019-04-22 |