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 |