| NPI | 1932396207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERI JONES Manager 270-252-0897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY 169528) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: KY 169528) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2017-11-08 |