| NPI | 1952059446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRIE GARCIA Owner 419-639-2010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224900000X Mastectomy Fitter |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2022-03-14 |
| Last Update Date | 2022-03-14 |