| NPI | 1952715849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE L POWELL Administrator 636-734-0386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2014-06-18 |