| NPI | 1851945802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAISY SCOTT Owner 318-716-1507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 224900000X Mastectomy Fitter |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2024-03-12 |