| NPI | 1831497056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER JOHANSON President 309-797-9099 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 203.000088) |
| Enumeration Date | 2011-03-11 |
| Last Update Date | 2011-03-11 |