| NPI | 1932619996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKSON PRESTON SIPLES Member 573-381-0410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2017-10-04 |