| NPI | 1073154845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KURT REIBER Owner 304-575-9868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2020-04-01 |