| NPI | 1871866418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN SALLOP Manager 512-614-8414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2012-02-13 |
| Last Update Date | 2012-02-13 |