| NPI | 1225372717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE LEIGH BRYANT Owner 304-445-4960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: WV LRTR0442) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WV LRTR0042) |
| 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies | |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2012-11-21 |
| Last Update Date | 2014-03-10 |