| NPI | 1902236177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RITA ILYASOV President 248-451-0073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2013-11-25 |
| Last Update Date | 2013-11-25 |