| NPI | 1912181793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIM L POTEET President 262-345-3081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WI 0786520002) |
| Enumeration Date | 2007-12-28 |
| Last Update Date | 2007-12-28 |