| NPI | 1801467139 |
|---|---|
| Doing Business As | THEIMG365 |
| Entity Type | Organization |
| Authorized Contact | DESHONDA CHARTRICE TUCKER Owner 682-351-7748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2021-07-07 |
| Last Update Date | 2021-07-07 |