| NPI | 1932380409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY R FREDRICK Owner/CPO 850-656-3599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: FL POR28) |
| Enumeration Date | 2007-11-26 |
| Last Update Date | 2007-11-26 |