| NPI | 1942869227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT ALLEN LOGAN Owner 936-291-6589 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2019-06-10 |