| NPI | 1841616398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORTNIE WELLMAN Manager/Member 936-582-1112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 1000226) |
| Additional Taxonomies | 261QS1200X Clinic/Center, Sleep Disorder Diagnostic |
| Enumeration Date | 2014-03-07 |
| Last Update Date | 2017-01-12 |