| NPI | 1912207754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD JOHN GROSSO Member 608-228-9090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: WI 456-1027152998-03) |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2010-10-27 |