| NPI | 1811142565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES JOHNSON Co Owner 573-341-2586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-11-22 |
| Last Update Date | 2008-11-22 |