| NPI | 1982774717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA JORDAN LACKEY Owner 985-726-0984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2020-08-22 |