| NPI | 1003913377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARIC VAN BROCKLIN Owner 434-971-8808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: VA 82480) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2008-03-26 |