| NPI | 1588725543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN NICHOLAS FICOCIELLO President 802-863-4591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2008-06-18 |