| NPI | 1558786475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORGE MANZANO Owner 571-340-8961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: VA 00000000) |
| Enumeration Date | 2014-02-28 |
| Last Update Date | 2014-02-28 |