| NPI | 1114932761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLEY MATUSIC Owner 304-757-1902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: WV 784978) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2010-12-14 |