| NPI | 1891923090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE C WALTERS Office Manager 662-844-9166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MS 17646) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2012-10-04 |