| NPI | 1841487774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA CRAVEN Owner 269-274-1414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 0099324) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: TX 0099324) |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2007-09-25 |