| NPI | 1912850603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INGRID MARIE WISVEY Authorized Official 469-915-5044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2026-02-20 |
| Last Update Date | 2026-02-20 |