| NPI | 1508055419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIL JEFFERY VICKS Owner 410-814-7616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MD 13016551) |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2007-10-16 |