| NPI | 1962595637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA C BOSTICK Owner/Operator 678-620-1147 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-08-22 |