| NPI | 1861966202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY GILDERMAN Manager 612-213-2879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-01-18 |
| Last Update Date | 2019-01-18 |