| NPI | 1982140760 |
|---|---|
| Former Name | SUSAN N MAHONEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: TX ATP87869) |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2017-01-17 |