| NPI | 1972080570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN MALOTT Compliance Manager 234-200-1382 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 171WV0202X Contractor, Vehicle Modifications |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2025-10-01 |