| NPI | 1003026352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM DUANE KELLER Owner 301-797-2344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: MD 1581) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |