| NPI | 1598016859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMEON CHARLES SLAYTON Owner 703-489-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: VA 2705 124382) |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2012-09-27 |