| NPI | 1992191548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RITA A DOLIN Office Manager 386-239-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: FL 10669) |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2015-04-13 |