| NPI | 1891102059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIZZIE ANDERSON Director 414-418-4410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2014-07-18 |