| NPI | 1831469063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK TRACY JOHNSTON President 320-358-3202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2012-01-04 |