| NPI | 1982136073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY CHANDLER Owner 541-513-0395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2017-03-29 |