| NPI | 1629237474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE KAY WICKLINE Office Manager 304-253-3150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WV 582-OD) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2008-06-20 |