| NPI | 1477720894 |
|---|---|
| Doing Business As | VILLAGE BOOTERY |
| Entity Type | Organization |
| Authorized Contact | TERESA ANN O'BRIEN Sales/Billing 772-283-3833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 5114170001) |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2008-05-14 |