| NPI | 1336486703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ANN SIMMONS Owner 304-893-7580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 347C00000X Private Vehicle |
| Enumeration Date | 2013-01-05 |
| Last Update Date | 2016-11-30 |