| NPI | 1417088899 |
|---|---|
| Doing Business As | WILLIE'S SPECIALTY SHOP |
| Entity Type | Organization |
| Authorized Contact | GARY PAUL TOLER Owner 714-771-4312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA I-105963-L) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2007-08-27 |