| NPI | 1942986484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM MARSHALL Credentialing Specialist 573-443-2402 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2023-06-27 |
| Last Update Date | 2023-06-27 |