| NPI | 1912223421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENDA M THOMPSON Owner 469-363-1286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2010-04-09 |