| NPI | 1013253004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES THOMAS CANELLA Owner 814-864-1277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: PA 6000007707) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Licence: PA 6000007707) |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2012-12-18 |