| NPI | 1578786521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN G CAUDILL Office Manager 703-255-2339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: VA 0119000683) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-08-22 |