| NPI | 1871820142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMARCO FORTEZ ALLEN Owner 469-222-1571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2009-11-07 |
| Last Update Date | 2009-11-12 |