| NPI | 1568647477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEN ROSELYN M LAZO Owner/Proprietor 757-761-1108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: VA 900980) |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2008-01-09 |