| NPI | 1962951442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD KUBIK Owner 417-693-3865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IA 489DLC-518480) |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2017-05-04 |