| NPI | 1801505961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARYL SCOTT CANEVA Owner 815-741-0791 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2022-11-17 |
| Last Update Date | 2022-11-17 |