| NPI | 1629133533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DYANE B PERGERSON Vice President 804-330-5743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: VA 0206008452) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2020-08-22 |