| NPI | 1992922025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA KAY STUART Office Manager 937-342-9260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2026-03-09 |