| NPI | 1992924948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CECIL PATRICK Store Manager 937-374-3226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: OH 29031606) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |