| NPI | 1962440347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN WEATHERLY President/Owner 912-351-0760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: GA 532291) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2020-08-22 |