| NPI | 1942495650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER A WIES President 254-412-0382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2007-09-06 |