| NPI | 1942499900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA G. JACKSON Adm. Asst. 336-768-1270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: NC 75970) |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2007-10-16 |