| NPI | 1962402263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ANTHONY CAPPS Owner 270-864-1606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY P07024) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2012-04-24 |