| NPI | 1548324148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA SUE SMITH Owner 757-499-9844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: VA 2101001551) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2020-08-22 |