| NPI | 1972971943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE BENJAMIN DAVIDSON Owner 573-881-1952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2020-09-11 |