| NPI | 1952673386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK M THEODOR Practice Administrator 937-641-3010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2012-02-01 |