| NPI | 1992826697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN RUSKIN Owner 866-798-0357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 1312793) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: FL 1312793) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2009-09-16 |