| NPI | 1376955799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL A DESILETS Owner 540-891-9565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: VA 2705125500) |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2014-05-21 |