| NPI | 1902477318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA FROMKIN Credentialing Mgr 706-494-3071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2021-07-07 |
| Last Update Date | 2023-08-18 |