| NPI | 1265823447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL DAWN COULTER Manager 304-587-9992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WV 2247-5308) |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2015-02-10 |