| NPI | 1972804375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONDA BERRY Owner 192-584-1758 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: CA 40013907) |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2010-11-16 |