| NPI | 1396349312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILIYA HERETSUN-ROUSSONICOLOS Owner 772-207-6266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2020-12-04 |