| NPI | 1568049138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIERRA LASHAE ROYSTER Admin Director 301-792-4607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2021-03-28 |
| Last Update Date | 2021-03-28 |