| NPI | 1487802583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS H JOHNG President 301-703-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: MD 16321832) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2015-07-30 |