| NPI | 1619212362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL ANN RYALL Mastectomy Fitter 860-865-0825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2012-12-06 |
| Last Update Date | 2013-05-16 |