| NPI | 1639442122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEBESSA DABA Owner 703-346-8796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: DC 27502xxxx-71101640) |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2012-02-15 |