| NPI | 1912197237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ROGER ALLEN President 910-738-3358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NC 9800444) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NC 98-00444) |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2009-05-04 |